“How do I change my pouch?” is a common question asked by ostomates when navigating their way through the new challenges of living with a stoma. Below are tips and hints, as well as some steps that could make the process of changing a pouch easier.
Tips and Hints
- If possible, establish a routine when changing your pouch.
- Changing the pouch when the stoma is the least active may help to make the process a dry change. If you have an ileostomy or urostomy, having no food or fluids overnight will mean the stoma may be less active first thing in the morning.
- Like any person using a toilet facility, pouch changes are a clean, NOT a sterile procedure. There is NO requirement for the use of gloves. As with any toileting function good hand washing is the only hygiene requirement. Health professionals are required to use gloves for the protection of all vulnerable patients in their care.
- It is normal to occasionally have small flecks of blood on the toilet paper or wipes used to clean a stoma.
- Preparing all equipment before removing your existing pouch shortens the time when your stoma could discharge without the pouch in place.
- Be gentle with your pouch removal, your skin is yours for life. Remove the pouch gently by easing it off with one hand/finger supporting the skin and the other hand gently peeling the pouch downwards. Using an adhesive remover product will also help prevent skin damage.
- With practice and increasing use of the product a pouch change is likely to be done in a few minutes.
Steps: How to change your pouch
1. Preparation
- Gather all equipment before starting
- Prepare the new pouch (cut out if needed, close outlet if drainable). In cooler climates a warmed pouch will stick more effectively, so if available, place the pouch over a warm towel rail
- Prepare any accessories
- Have warm water available in the vanity sink or separate container if preferred, along with toilet paper or wash cloths for cleaning
- Disposal or rubbish bag for used products should be in easy reach
- Wash your hands before starting the change
- If using a drainable pouch, empty contents into the toilet
2. Removing used pouch
- While supporting the skin with one hand, gently peel downwards to remove existing pouch (refer to image)
- If using an adhesive remover lift the edge of the pouch adhesive area and wipe or spray the remover along the exposed skin pouch edge. Move towards the centre of the pouch and the stoma as the pouch lifts away
- Inspect the adhesive area of the removed pouch looking for any contamination, or tracking of content under the adhesive
- Place used pouch in disposal bag
- Check skin for any redness
- If needed check the cutting pattern size by placing it over the stoma and checking in the mirror for correct fit. The pattern should fit snuggly, clearing the stoma by 1-2mm
3. Preparing the skin
- Clean the skin and stoma. Once toilet paper or wash cloth has made contact with the stoma do not place it back into the water. This keeps the water and the sink clean
- Washing the skin and stoma in the shower may also be preferred
- Pat the skin dry
- If needed, remove any hair which is interfering with pouch adhesion (Ask your specialist nurse on the best method of hair removal if this is needed)
- If required apply skin protection
4. Fitting the new pouch
- Remove backing from adhesive area on the new pouch
- If using a drainable pouch ensure it is correctly orientated with the outlet at the bottom so you can easily empty the pouch
- Position the pouch, then press into place
- Place your hand over the adhesive area for a minute, as the warmth from your hand will increase pouch adhesion.
5. Cleaning up
- Discard rubbish in outside bin and wash your hands
