What are the Different Types of Ostomy Wafers & Barriers?

What is an Ostomy Wafer or Barrier?

Ostomy wafers are the same thing as ostomy barriers. The ostomy barrier is the part of the appliance that goes against the skin and has a hole that fits around your stoma. The ostomy barrier is often called a flange, wafer, device, or appliance. An ostomy barrier sticks to the skin around your stoma by using adhesive. The skin around your stoma is called your "peristomal skin" and surrounds your stoma. The ostomy barrier goes around your stoma and protects your skin from stomal output. The ostomy barrier also allows your ostomy pouch to connect to your body. If you use a two-piece ostomy system the wafer and pouch are two separate pieces that each have their own unique item numbers. Not all ostomy barriers fit all pouches. If you use a one-piece ostomy system the wafer and pouch are always connected and can not be separated. Technically, the ostomy flange is the actual plastic device that connects to the ostomy pouch, the flange is the coupling device. They are generally in a square shape and come in pre-cut, cut-to-fit, and moldable varieties.

What are Pre-Cut Ostomy Barriers (Wafers)?

These wafers are made with the most common sizes of stomas in mind. They are uniform and circular in shape. The biggest bonus to pre-cut barriers is that you don't have to cut them, just open the box and they are ready to go. If your stoma fits the size they offer and if your stoma is evenly round, then these can save you a lot of time. If your stoma is not round or a standard size, these may not be the best choice for you. When you first get your ostomy, you are going to want to avoid the pre-cut wafers, even if your stoma is perfectly round and standard in size. This is because your stoma is still changing. It takes time for swelling to go down and for your stoma size to settle.

What are Cut-to-fit Barriers (Wafers)?

Designed with varying sizes printed directly on them so you can cut your own opening to fit your individual stoma size and shape. These printed lines function as a guide. You are not limited to a pre-cut circle, you can make an oval, circle, any kind of shape you need to fit your specific stoma. This is a great option for those who are in between sizes or have an irregular stoma shape. The easiest way to handle the cut to fit style of ostomy wafers is cut the wafers for the day or week ahead of time. Don't wait till you need them, cut several at the same time so you won't have to fumble with cutting while away from home. Be aware that many airports won't allow you to carry-on even small scissors, so make sure you check them and have your wafers cut before you board the plane. Coloplast Sensura Mio is one example of cut-to-fit barriers but each ostomy supply company has their own version.

What are Moldable Wafers?

Moldable wafers are a one of the newer technologies compared to some of the other types of ostomy wafers. The moldable aspect is a lot like a "cut-to-fit" with some added bonuses. The material they are made of is stoma safe. The moldable material is designed to be able to go right against the stoma itself without causing damage to the stoma or surrounding skin. The flexible material can be molded and shaped to fit around your stoma snugly. This doesn't require any scissors, you can use your fingers to roll and shape the wafer around your stoma. The process of molding the wafer around the stoma is called "turtle necking" and is usually done in a conical shape around the stoma. Turtle necking provides the best protection from leaks and increases comfort since the stoma and surrounding skin is not exposed to stoma output. Moldable wafers are meant to fit snugly around your stoma which can increase wear time while decreasing skin complications. Convatec offers moldable wafers as a part of their Sur-Fit Natura line of ostomy systems.

What is a Floating Flange?

A "floating flange" is a thin and flexible ostomy wafer by Hollister, it allows you to put your fingertips under the flange itself for support which makes connecting the pouch to the wafer easier. This means that when you are fresh from surgery and sore you won't have to press into your tender stomach until your wafer clicks into your pouch. The floating flange is helpful when you have dexterity issues. Hollister uses the floating flange in pre-cut, cut-to-fit, and their new Cera Plus ostomy wafers. Floating flange is also available in the convex style for anyone with a flush or recessed stoma.