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Decrease the potential risk of stoma leakage 

Convex ostomy bags - a solution for your patients?

Stoma complications can occur within one month after surgery but also at a later stage.[1] Some of the contributing factors may be the stoma placement, its characteristics, fistula formation or a high liquid output.[1] When any of these obstacles arise, effluents may irritate the peristomal skin and even seep under the stoma wafer.[2] As a result, the adhesion of the device can be compromised, and the surrounding area may also be irritated.[3]

Macro of Flexima Active O' convex wafer with green lines highlighting soft convexity

If your patient suffers from stoma leakage, a convex stoma appliance may solve the issue. You can determine whether it is suitable by assessing the type of stoma and the patient’s abdominal contours.

Convex bags may help to avoid stoma leakage

A convex ostomy bag system can possibly make the appliance adhere better to the surrounding skin to prevent stoma leakage, which is a frequent worry[4,5] for many ostomates. Convex ostomy bag systems are designed to[6,7,8,9]

  • apply sufficient pressure around the stoma to smooth out peristomal contours, especially in creases and skin folds, to ensure the wafer forms a tight seal with the skin.
  • exert the right amount of pressure onto the peristomal skin, to allow the stoma to protrude further inside the bag. This improves the drainage of stoma effluents into the bag and is especially helpful with retracted or flush ostomies.
  • make accessories such as convex barrier rings unnecessary.

The choice of soft convexity can bring additional advantages[8,9]

  • flexible enough to adhere to and form a seal with the patient’s body profile while they move and change position.
  • even more comfortable to wear for your stoma patient.
     
When should you suggest a convex stoma system?
Man with stoma bag on naked upper body with male nurse with gloves indicating him how to apply the bag

Every ostomy is different and often, convexity can be a great help. To select the right device, the appliance must be adapted both to the anatomical conditions and dynamics of the patient’s abdomen as well as to the characteristics of their stoma. Therefore, convex stoma bag systems differ among other thing in angle, shape and depth of the convexity.[10]

Ultimately, it is your clinical experience which determines whether you recommend a convex system to your patient and what properties it should possess.

Convex appliances may be appropriate for[7]

  • Flush stoma: A stoma should be 2.5 cm in length, so the seal around the base of the stoma can work well. However, if a stoma sits at the level of the abdominal skin, it is considered flush.
  • Retracted stoma: A retracted stoma sits below the level of the skin. This may have been caused by a technical difficulty during surgery or by postoperative weight gain.
  • Telescoping stoma: Especially at night, when patients are supine, the telescoping stoma can slide towards or below skin level.
  • Poorly placed stoma: If a stoma was formed during an emergency surgery while the patient was supine or had a distended abdomen, the result may be not optimal.
  • Folds of peristomial skin: The skin may form canal-like folds that cause leakage.
  • Soft abdomen: An abdomen with weak muscle tone provides little support for the stoma, resulting in contours in the peristomal plane.
  • High-output stoma: When the stoma discharge exceeds 750 milliliters per day, the likelihood of leakage rises. The same applies if the output is of a rather liquid nature.

Liquid discharge has the potential to seep into smaller gaps in the skin more easily than formed stool and crosses the skin barrier faster, even with well-protruded stomas. In such cases, convex-shaped products can increase the wear time of the wafer.[2,11]

Our offer of convex ostomy bag systems

Depending on individual needs, you always have the option to choose between standard or soft convex stoma bags with deep or medium convexity. B. Braun has a whole range of convex options to suit your patients‘ needs. Find a good solution for each individual patient.

Gently sloping convexity
Illustration of the convex cross-section of a wafer with description

Gently sloping convexity is a feature of all 4 to 6 mm products. It was developed to provide better pressure distribution and to apply sufficient pressure around the stoma to shape and form the patient’s peristomal contours.

Intensify convexity effect with a stoma belt

To create a higher sense of security, many users recommend the use of a stoma belt to intensify the effect of convexity. Three different attachment positions* allow the belt to match the preferred position of the bag on the abdomen.

Illustration of convex stoma bag applied around a stoma

Highlight product

Hand presses the wafer of a soft convex stoma bag to demonstrate its flexibility
portrait of the woman with glasses

“I’ve seen some great results using Flexima Active O ´convex with patients with "uneven" peristomal surroundings. The soft convex is "soft enough" and has the "needed pressure" for this kind of skin. You know the bellies and stomas are usually not ideal, as literature shows. But our patients need the help to live normally. And one solution for me now is Flexima Active O´ convex.”

Mgr. Zuzana Šilhánková, Ostomy Nurse, Czech Republic
portrait of the woman smiling

“I love Softima Active Convex Uro. It gives me the option to use a soft convex appliance (and belt) on some friable post-op stomas where I might be hesitant to use a "normal" convex one. I’ve seen some great results using this with patients recently where I was worried about pressure around the mucocutaneuos junction. I find the convexity is soft yet stable and that’s what makes the difference!”

Kayleigh Brownlee-Moore – United Kingdom

Product overview

Our offer of one-piece convex stoma bags

Flexima®

Moderate convexity of 4 mm can help make the stoma protrude.

Side view of Flexima Active O' convex wafer of 4 mm depth

Flexima® Convex Drainable Bags

With its flower shaped hydrocolloid skin protector, Flexima® drainable bags adapt well to body contours and give added comfort to people with an enterostomy. Flexima® convex drainable stoma bags are designed for people with flush or slightly retracted stoma. Their outlet have an integrated Roll'up clamp.

Flexima® Uro Silk Convex Urostomy Bags

With its flower shaped hydrocolloid skin protector, Flexima® Uro Silk bags adapt well to body contours and give added comfort to people with a urostomy. The convexe urostomy bags offer an anti-reflux valve to avoid urine backflow and an easy to handle and secure B. Braun drainage tap with 'open' and 'close' positions.

Our offer of two-piece convex stoma systems

Flexima® 3S with mechanical coupling system

Moderate convexity of 6 mm can help fill in medium to deep hollows and the folds in the skin.

Side view of Flexima 3S convex wafer of 6 mm depth

Flexima® 3S Convex Wafers

Flexima® 3S is a 2-piece range with a guided mechanical coupling system for an easy positioning of the stoma bag onto the wafer. Flexima® 3S convex wafers are designed for flush or slightly retracted stomas to be used with the Flexima® 3S closed, drainable or urostomy bags. Full skin protector layerGentle convexity of  6 mm, designed to provide a sufficient level of pressure, evenly spread out on the peristomal areaMechanical flexible coupling ring with guiding system allowing three different bag positionsSlots for belt fixation, three different positions availableAvailable in: Ø45 mm: cut-to-fit Ø15-26 mm and pre-cut Ø25 mmØ55 mm: cut-to-fit Ø15-36 mm and pre-cut Ø30 mmØ65 mm: cut-to-fit Ø15-46 mm  Boxes of 5 wafers

Flexima® 3S Drainable Bags

Flexima® 3S is a 2-piece range with a guided mechanical coupling system for an easy positioning of the stoma bag onto the wafer. Its ergonomically shaped drainable bags have an integrated Roll'up soft clamp. They are available in two different sizes, midi and maxi.   Intuitive and secure closing system: Outlet with integrated self-gripping soft clamp7 cm wide outlet openingThe edges are softened to increase the wearing comfort once the Roll'up outlet is closedOnce folded and closed, the drainable bag has a shape as compact as of a colostomy bag.   High performance protected filter (HP): Improved deodorization capacity through its high-tech breathable membraneLeak-proof and permeable to gases   Colors and capacity (volume as per ISO 8670-2): Midi: Ø45 mm: capacity of +/- 650 ml, beige and transparentØ55 mm: capacity of +/- 635 ml, beige and transparentØ65 mm: capacity of +/- 615 ml, beige and transparent Maxi: Ø45 mm: capacity of +/- 805 ml, beige and transparentØ55 mm: capacity of +/- 785 ml, beige and transparentØ65 mm: capacity of +/- 755 ml, beige and transparentØ80 mm: capacity of +/- 715 ml, beige and transparent Box of 30 bags   Material: Soft non-woven and odor-proof plastic filmFree of latex (PVC) and phthalates (DEHP)

Flexima® 3S High Flow Bags

Flexima® 3S is a 2-piece range with a guided mechanical coupling system for an easy positioning of the stoma bag onto the wafer. The Flexima® 3S High Flow bags are designed to collect a large quantity of body effluents.    Compact bag shape with large outlet: Ergonomic and optimized bag design for large capacity with funnel-shaped lower part14 mm large outletCan be connected to the Flow Collector, a distal collecting bag To be used with the Flexima® 3S wafer corresponding to the chosen diameter of the bagBox of 30 high-flow drainable bags   Colors and capacity (volume as per ISO 8670-2): In addition to the transparent bags we are offering also beige split cover bags (with inspection window) that combine both the discretion of a beige stoma bag and the visual control to check easily stoma or stool aspect and quantity. Ø55 mm: capacity of +/- 970 ml, beige with inspection window and transparentØ65 mm: capacity of +/- 940 ml, beige with inspection window and transparentØ80 mm: capacity of +/- 900 ml, beige beige with inspection window and transparent   High performance protected filter (HP): Improved deodorization capacity through its high-tech breathable membraneLeak-proof and permeable to gases   Material: Soft non-woven and odor-proof plastic filmFree of latex (PVC) and phthalates (DEHP)  

References

 
  1. Malik T, Lee MJ, Harikrishnan AB. The incidence of stoma related morbidity - a systematic review of randomised controlled trials. Ann R Coll Surg Engl. 2018 Sep;100(7):501-508. doi: 10.1308/rcsann.2018.0126. Epub 2018 Aug 16. PMID: 30112948; PMCID: PMC6214073.
  2. Evans M, White P. Selecting convexity to improve and maintain peristomal skin integrity. Br J Nurs. 2020 Sep 10;29(16):S8-S14. doi: 10.12968/bjon.2020.29.16.S8. PMID: 32901550
  3. Andersen NK, Trøjgaard P, Herschend NO, Størling ZM. Automated Assessment of Peristomal Skin Discoloration and Leakage Area Using Artificial Intelligence. Front Artif Intell. 2020 Sep 10;3:72. doi: 10.3389/frai.2020.00072. PMID: 33733189; PMCID: PMC7861335
  4. Rolls N, Yssing C, Bøgelund M, Håkan-Bloch J, de Fries Jensen L. Utilities associated with stoma-related complications: peristomal skin complications and leakages. J Med Econ. 2022 Jan-Dec;25(1):1005-1014. doi: 10.1080/13696998.2022.2101776. PMID: 35833520.
  5. Nafees B, Størling ZM, Hindsberger C, Lloyd A. The ostomy leak impact tool: development and validation of a new patient-reported tool to measure the burden of leakage in ostomy device users. Health Qual Life Outcomes. 2018 Dec 14;16(1):231. doi: 10.1186/s12955-018-1054-0. PMID: 30547808; PMCID: PMC6295083.
  6. Cronin E. A guide to the appropriate use of convex stoma care products. Gastrointestinal Nursing 2013; Vol. 6, No. 2. DOI: 10.12968/gasn.2008.6.2.28803. ISSN: 14795248
  7. Perrin A. Convex stoma appliances: an audit of stoma care nurses. Br J Nurs. 2016 Dec 8;25(22):S10-S15. doi: 10.12968/bjon.2016.25.22.S10. PMID: 27935354.
  8. Hoeflok J, Salvadalena G, Pridham S, Droste W, McNichol L, Gray M. Use of Convexity in Ostomy Care: Results of an International Consensus Meeting. J Wound Ostomy Continence Nurs. 2017 Jan/Feb;44(1):55-62. doi: 10.1097/WON.0000000000000291. PMID: 28002174; PMCID: PMC5266410.
  9. Turnbull GB. 2003. The Ostomy Files: The Convexity Controversy. https://www.hmpgloballearningnetwork.com/site/wmp/content/the-convexity-controversy. Accessed November 1, 2022.
  10. Hoeflok J, Kittscha J, Purnell P. Use of convexity in pouching: a comprehensive review. J Wound Ostomy Continence Nurs. 2013 Sep-Oct;40(5):506-12. doi: 10.1097/WON.0b013e3182a219b7. PMID: 24448619.
  11. Richbourg L, Thorpe JM, Rapp CG. Difficulties experienced by the ostomate after hospital discharge. J Wound Ostomy Continence Nurs. 2007 Jan-Feb;34(1):70-9. doi: 10.1097/00152192-200701000-00011. PMID: 17228210.

* except for Proxima® 2+, which has one hooking position for the belt