Replacing a Two-Piece Ostomy Bag: Step-by-Step Guide

In daily life, some individuals require the use of a two-piece ostomy bag, a medical device used to manage gastrointestinal or urinary ostomies. Replacing a two-piece ostomy bag may be necessary, either as part of routine care or due to wear and tear on the existing bag. In this blog article, we will provide a detailed step-by-step guide to assist you in the proper procedure for replacing a two-piece ostomy bag while maintaining hygiene.

Step 1: Gather Your Materials

Before beginning the process of changing your two-piece ostomy bag, ensure that you have the following materials and tools at hand:

  • Two-piece ostomy baseplate and bag
  • Ostomy seal or paste
  • Ostomy measuring guide
  • Toilet tissue
  • Cotton swabs
  • Scissors
  • Waste disposal bag
  • Warm water, and more as needed

Step 2: Remove the Old Ostomy Bag

Gently lift the edge of the old two-piece ostomy bag, supporting the surrounding skin with your other hand. Carefully peel away the old bag, ensuring not to tug or harm the skin. If there are any residues on the skin, you can gently cleanse the area with warm water and mild soap, followed by patting it dry with a towel.

Step 3: Assess the Baseplate and Skin Condition

First, check the removed baseplate for any signs of excrement. Inspect if the adhesive has turned white and foamy or if there is erosion or adhesive dissolution.

Next, examine the condition of the skin around the ostomy:

  • Check for any remaining fecal matter on the skin, indicating prior leakage.
  • After cleansing the skin, ensure that the skin color appears normal.
  • Normal skin beneath the ostomy baseplate should match the color of the skin on the opposite abdominal side, without any damage. Any signs of discoloration, redness, itching, or skin breakdown suggest skin issues.

By examining the baseplate and skin conditions, you can assess if there was a prior leak or extended wear, which may require a shorter wearing duration.

Step 4: Clean the Ostomy Site

Wipe away any fecal matter at the ostomy site with toilet tissue. Then, clean the skin around the ostomy and the ostomy mucosa using a moist cotton swab or damp toilet paper. Ensure that you keep the skin and mucosa separate during cleansing, prioritizing the mucosa for cleaning before the surrounding skin.

Step 5: Measure the Ostomy Mucosa

Accurately measure the diameter of the ostomy mucosa (the base of the stoma) using the ostomy measuring guide.

Step 6: Cut the Baseplate Hole

Cut the center hole in the baseplate, ensuring it is 1-2mm larger than the measured stoma diameter. If your stoma is oval or irregular in shape, follow the measurements taken earlier and mark accordingly.

Step 7: Use Ostomy Seal or Paste

Apply ostomy seal or paste to the skin surrounding the stoma. This can be done by either stretching the seal or paste ring over the stoma or by cutting a portion of the ring and wrapping it around the stoma in a scarf-like fashion, ensuring a snug fit and pressing it down firmly.

Step 8: Attach the Baseplate

Remove the protective paper from the adhesive side of the baseplate and position it over the stoma, adhering it securely to the surrounding skin by starting from the inner edge and working outward in a clockwise motion. Pay special attention to firmly pressing down on the central hole of the baseplate, making circular motions with your fingers to ensure a secure fit.

Step 9: Install the Ostomy Bag

Close the outlet on the ostomy bag. With both hands, grasp the ostomy bag and, using a four-point method, attach the bag by snapping it from the bottom to the top. Finally, lock the fastening clamp, listening for the reassuring "click" sound.

We hope that these steps will be of assistance to those in need. The KONWEDA medical team is here to support you, ensuring that we take good care of your ostomy, leaving no room for leakage.

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