Proper Sizing of Ostomy Bag Hole for Irregular Shaped Stoma (2024)

How frustrating for you! The first couple of weeks after surgery my stoma was oval. The nurse used the template that comes with the barrier and we measured in several different places, dotted the wafer, connected the dots and cut out the oval leaving no more than 1/8” of skin. (Actually, the nurse did fit the barrier closer to the stoma without covering it). The only time I’ve had skin issues is when I don’t set the barrier right and have too much skin exposed to the “output”. Thankfully, now post-op enough my stoma is a perfect 1 1/8” precut round. Hope it stays that way. Good luck!!

Hi LouAP. I have a Urostomy but urine on bare skin can be just as problematic. My stoma is oval so I measure in 2 directions and cut very close - I’m sure less than 1/16 inch larger and I don’t really have any skin issues. The reason, I think, is that I use the skin barrier wipes and apply right up to the stoma. This creates a noticeable barrier between the skin and the appliance and the barrier sticks to it very well. If you’re not using a barrier film, try that.

My bags comes with several circles to use as a guide when cutting, but i found out years ago to cut the hole just big enough to go over the stoma when applying. over the years(12 of them) i found that just inside the first circle is a perfect fit................................

Thanks

Do you put a ring around your stoma first before applying the wafer? The ring will abut the stoma and keep the poop from getting on your skin. The wafer is cut just a little bit bigger and allows for the changing of the shape of the stoma is it poops.

Anyark - Do you (or anyone) have a problem with the ring as it “melts,” coming up above the wafer hole because of it being cut a bit larger? Is that normal?

Yes I do use a ring but I stretch it to follow the cut out on the wafer. So maybe it does not abut the stoma.

I find that using a barrier ring applied to the back of the wafer, applied to my belly then followed by a ring of stoma powder keeps any feces off my skin. The barrier ring does 'melt,' but may not abut the stoma; so that's where the stoma powder comes into play. This has worked for me since I had my surgery almost 2 years ago.

That’s normal. It fills in the space.

I like thicker rings from Brava. They come in two or four millimeters thick. They can also be ordered precut. My ostomy nurse showed me how to apply it to the wafer and to stretch the edges up and around the hole for the pouch. Then apply it to your skin. This has helped my skin problems a lot.

it is almost impossible for me too to get a perfect 1/8" gap. It is mainly round but there are 2 areas that have a small "pimple" sticking out. YOu would think I could deal with it but even when I try to cut it similar,by time I apply the pouch I always seem to miss the area intended or have the bag going in the wrong direction (to one side too much). I do not like how the moldable rings and gooey sheets melt up into the gap as you have said so I use 2 products that do not do that but that I can "wrap" around the stoma without a gap by slicing them. One is the SafeNSimple protective barrier sheets 4" square. Because I am so small and I only want to protect that small gap area I cut these squares into 4 squares then cut a 24mm circle (for my need) and a slice so I can wrap it. IF I want more I will use Coloplast's Brava Protective seal 2.5mm. They are not gooey and do not grow like the Brave moldable rings that make a mess in the bag by thickening my output. I have found many products do this and I do not like it because it makes it hard to clean the bag and for me to clearly see the white area that I use to tell if it is time to change the bag. Hope this helps!

I got rear-ended (No pun intended) at 8 weeks post op. My seatbelt distorted my stoma shape. Slightly oval with a Northeast projection. Trying to align the wafer is difficult. Now I use a half of a Brava paste strip to fit the stoma, and cut the wafer to the max measurement of my stoma. When the wafer is applied the paste strip "turtle necks" around the stoma, and protects the irregularities.

the strip for me just oozes all over into the bag and mixes with the out[put. Maybe because my output is thin and it is a lot. Not sure. I wish it did work for me as it is a fairly easy for irregular shape stoma.

I have had an irregular stoma for 30 years and occasional irritated skin because of exposed skin around the cut flange. Things are a little complicated by the lack of totally smooth skin due to scar tissue from loop ileostomies etc. I just found some moldable flanges from Convatec. There is no cutting required and you just roll the flange material back to the approximate size and shape of the stoma. I use a 2 piece system so I can then accurately place this on the stoma. The flange seems to roll back to meet the stoma edge and leaves no gap. I have been using them for about 4 weeks and find that it seems to be working really well, the irritated skin has healed and it also shortens the time for a "bag swap". Also I used to pre-cut flanges if travelling etc but there is no need with these moldable versions. I will update if I notice any real downsides but at the moment they seem to be working well for me.