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Ostomy adhesive is a material applied to the skin around a stoma — the external opening around an ostomy — to temporarily anchor the small flat plastic "plate" of the bag or appliance to the skin, to avoid leakage of the excretory substance or effluent onto the skin, to prevent damage to skin around the stoma from the adhesive or the action of the fluids and to avoid odor. Early ostomy adhesives sought mainly to control leakage. Modern products are designed with many factors in mind. The specific type of ostomy adhesive recommended by an ostomy nurse is determined by a combination of factors: the patient's abdominal tone; the position of the stoma relative to the surrounding skin and any scars or skin folds and other characteristics of the stoma, such as one with frequent or high discharge; the appliance type; and the period of time that the patient must wear the appliance.
There are several types of characteristics that an ostomy adhesive must demonstrate. Not only must it provide a protective seal against the effects of effluents, the adhesive must demonstrate resistance from erosion secondary to the effluents, must not affect the skin's potenz hydrogen (pH) level, must qualify as hypoallergenic, must absorb moisture and cannot stress the skin by leaving irritating residue or strip away skin layers during removal of the appliance plate. Ostomy adhesives vary in their provision of these characteristics, so a patient's choice of an adhesive might vary. A patient's choice of a specific ostomy adhesive might vary to treat increased skin irritation or to meet needs such as planned longer appliance wear time or outside wear time during hot days.
Another characteristic that a patient must considered when choosing an ostomy adhesive is his or her preferred appliance system. Ostomy appliances usually are either one-piece or two-piece systems. A one-piece system usually is used for shorter periods of time — a few hours — and is replaced more frequently.
A two-piece system consists of a plate surrounding the stoma and a coupling system to attach sequential bags. Two-piece systems usually intend for the plate against the skin to remain in place for longer periods, such as days. Some ostomy adhesives are designed for hours of use, and others are expected to maintain adhesion to the skin for days.
Flexibility is another characteristic of ostomy adhesives that a patient must consider. Flexible adhesives will move with the body and will thus be more comfortable for an individual who has an active lifestyle. Their length of wear time is generally shorter, however, than other choices because of the movable aspect of their seal. As expected, flexible ostomy adhesive is more easily removed from the skin than rigid alternatives.
Lastly, the choice of an ostomy adhesive might depend on the patient's ability to manipulate the appliance adhesive. In some cases, patients are incapable of fully visualizing the stoma area. These cases require the ostomy adhesive to be applied to the appliance plate, which is then pressed to the skin around the stoma and thus cannot be in a dry form. For patients who are incapable of performing the self-care of an appliance change independently, the adhesive choice can depend on the patient's lifestyle, mobility and personal preference.