Patient/caregiver was educated on two piece ileostomy as follows:
- Two piece ileostomy is a device in which the wafer and the ileostomy bag are separate and are two different units. As they are two separate units, two piece ileostomy has the advantage of discarding just the wafer or the bag for a defect or leak or blockage and yet retain the other piece, which can save you supplies that last longer. Also, two piece ileostomy bags have belt tabs for extra securement of the bag to the wafer, which can also result in longer lasting supplies.
- Two piece ileostomy is comparatively expensive than a one piece ileostomy and so, is discouraged by the insurance. For individuals paying out-of-pocket, the price difference between one and two piece could be significant, which makes one piece more preferred.
- Maintaining the inventory is comparatively cumbersome with two piece ileostomy bags, as you are bothered with two separate units versus maintaining inventory of one single unit of one piece ileostomy.
- Two piece ileostomy bags can be a little rigid due to the plastic in the wafer & coupling ring and can be harder to fix in individuals with difficult body contours. One piece ileostomy bags are softer, more pliable, and so can be more securely fixed against difficult body contours.
- Two piece systems offer the flexibility of rotating the bag to a comfortable position after securing it in place, which makes them preferred for some individuals.
- Two piece ileostomy bags have a flange connecting the bag to the wafer and one piece bags lack the flange, as the wafer and bag are fused into one single unit. The presence of flange in two piece bags can allow some extra space for the ileostomy, which offers some protection to the ileostomy site.
- High-output ostomies can be difficult to manage with one piece bags, as the weight of increased output volume in the bag can cause easy detachment of the bag, thus necessitating a replacement. Wearing an ileostomy belt can offer more security and contribute to longer lasting bag. Two piece ileostomy bags are more preferred to manage high-output ostomies. If the wafer/skin barrier gets detached, you have the option of replacing that piece alone yet retaining the bag. With extremely high-output ostomies, two piece ileostomy bags can also come with a locking device. The locking device helps to lock the bag and wafer together, thus eliminating the risk for bag detachment from the wafer. Also, anchoring the belt tabs in place can offer more secure fixing of the wafer against the skin, contributing to longer-lasting supplies. Emptying the bag periodically can help holding the bag good longer.
- If an individual is producing too much of gas, separating the bag slightly from the wafer can allow burping the bag with two piece arrangement. Burping with one piece ileostomy bag can be performed by emptying the bag periodically, which can be difficult at times. Burping an ileostomy bag could also be performed by fixing an osto-ez-vent appliance on the bag. This appliance is a vent on the bag, which can be opened for gas to escape from the bag and closed back again.
