One Piece vs Two Piece Ostomy Appliances

One piece pouching systems include both parts in one piece. The baseplate is permanently attached to the pouch. One piece pouching systems are simple. They’re compact. And they’re a great choice for many people.

Benefits of a one piece system:

• Usually a lower profile (less noticeable under clothes when empty)
• Cost is less than a two piece (usually)
• More flexible baseplate = can contour to body more easily (good for hernias)
• Less product to keep track of
• Your pouch won’t come apart from your wafer, though your wafer can still come off your skin causing a leak
• Good for people with dexterity problems who may have trouble connecting the two piece securely

Disadvantages of a one piece system:

• Can’t “burp” your pouch to let out excess gas
• Have to be changed often if they’re accompanied by a closed-end pouch (see Drainable vs. Closed End)
• Once you put it on, that’s how it stays until you change it (can’t rotate or change pouch size without doing a whole system change)
• Getting a good fit can be challenging
• Have to make sure you don’t cut the pouch when you’re cutting the baseplate to fit around your stoma
• Changing your whole system frequently can break down the skin causing irritation

 

Two piece pouching systems are two separate pieces – the baseplate is separate from the pouch and they are connected by a coupling system. Different manufacturers offer different coupling systems. When you order two piece pouching systems, it’s good to check that what the company sent you matches up (1 ¾” baseplate coupling will not fit 2” pouch coupling). Testing them out to make sure they fit each other BEFORE you use them and have the baseplate on your stomach is a good way to prevent some stress and frustration.

Benefits of a two piece system:

• Better visibility when measuring that the hole in the baseplate fits nicely around the stoma (less chance for leaks)
• You can replace the pouch without changing the baseplate, less skin irritation.
• You can change the angle the pouch hangs if you like, and then change it back later.
• If you have a closed-end pouch, it’s really fast to switch out a full pouch and replace it with a new one.
• You can open/uncouple the top of the pouch to let out excessive air (a technique called “burping”).

Disadvantages of a two piece system:

• Slightly more visible than a one-piece pouch if you’re wearing clothing that allows it to be visible.
• The pouch can separate from the baseplate causing a mess (rare though!)
• Cost: typically more expensive than one pieces
• You likely wear your baseplate for longer so skin irritation or small leaks under the baseplate may not be detected as quickly.