hey guys it's Eric in today's video I'm going to be talking about the pros and cons of a one-piece
versus a two-piece Ostomy appliance. Stay tuned.
Ok so before we get started I'd like to just say that there's no right and wrong appliance. Everything that I'm going to show you is based on
just personal preference whether you want to go with one system or another. I will be explaining
some of the pros and cons to each of these systems based on my own experience, but feel free
to add your own comments to the comments section below. So let's get started with this. I'm going
to start with the one piece system because this is the most simple system for an ostomy supply,
and some people may be more familiar with this over the two-piece, but when we're talking about
a one-piece appliance what we're referring to is the wafer and the actual bag are fused
together to form one piece. So there's no extra supplies needed this is basically all you have
to carry around with you if you need to do a basic Ostomy appliance change. Now, some of the benefits
to having a one-piece system is the fact that because there's no flange there connecting the
bag to the wafer it's incredibly thin. You really can't get much thicker than this unless you're
going with an adhesive coupling two-piece, which I'll explain later on in the video. But the one
pieces are pretty easy to manage. I mean, there's very little you have to worry about, other than
getting it on. Some people might find it a challenge, especially if they have an opaque bag,
because they can't really see how much of the stoma is being exposed or how much of the skin
around the stoma is being exposed. It's hard to get a perfect fit when you can't see what's
going on as you can with a two-piece. So that's one disadvantage to this. Another thing about a one-piece
is that they tend to be less expensive than two-piece systems, and for some people that
pay for supplies out of pocket, those dollars here and there will add up. So that's
another thing that I would say is a benefit to a one-piece. I know for some people who are
really trying to penny-pinch or they may not have insurance for supplies, wearing a one-piece might
have another disadvantage and the fact that you can't just remove the bag and reuse that bag by
rinsing it out, and that sort of thing, which I know some people do with two-piece systems. So that's
obviously something that not everybody needs to do, but if you happen to be in that situation a one-piece
might be ruled out in that case. In addition to that, if you have to change your appliance early,
so let's say for example you just put on a fresh appliance in the morning, and by the afternoon you've
got some kind of leak or something going on with that, with a one-piece system you have to change
the whole appliance. That means your bag goes out with your wafer. Now that can end up costing a
lot of money if you're doing that often, whereas if you're using a two-piece system, you can just
remove that bag, change your wafer, put that bag back on if everything is still "fresh "
on it, so if the filter isn't clogged and that sort of thing. Now, for people who like to wear their
appliance horizontally like I do, when you have a one-piece system you basically have to set it and
forget it, but you can't rotate it afterwards if you have that preference later on. So you're either
putting it on one way or the other, you don't have the flexibility of doing it both ways like you can
with some of the two-piece systems. Now, for some people who like to travel or just like to keep
things simple, a one-piece system is a great idea because it's really compact. You can very easily
pack them without any extra bulk, and you only really have to order one box of supplies rather than two.
You only have to manage one supply rather than two. So it's a lot easier to manage when you
have accessories here and there and you need to keep these all together, so that's another
big advantage to these. Now, for some people that have easy stomas, you know they're not problematic,
a one-piece is probably going to work for them without any issues because they can
wear their appliance for 3, 4, 5, or 7 days, whatever it may be, and then they just change the whole thing
and stick a new one on, so there's no real issue with that. Some of the disadvantages ,however, with
a one-piece is the fact that if you have to change just the bag on its own, and for some people that
might be because their filter gets clogged, or in a couple of cases that I've had I've actually
had the bag tear on me, or the actual outlet fail on me in some way, and there's no easy way
to replace that if you have to replace the whole appliance. So when you have a two-piece system you
can actually just change the bag on its own and then you're good to go. So that's another thing.
So one other problem that some people may have with a one-piece system is the fact that you
can't "burp" your appliance the same way you would on a two-piece. For most people who are "burping"
their appliance, they tend to just separate the flange area, let a little bit of gas out, and then
snap it back together. On a one-piece system you can't really do that. You have to go through the
bottom if you want to "burp" your appliance, and that requires you usually to lay down and there's a few
extra steps there, so it's not as convenient. Now, you'll notice one thing on the one-piece system
that you tend to see on the two-piece system, and that's the fact that they don't have the
belt tabs. Now that's because on a one-piece system really you're not going to have a risk of the
bag detaching because it's all fused together, and that's usually why you would have the belt tabs
on a two-piece system. Now, some people may find that a one-piece system is more comfortable on
their skin, especially if they have a hernia or some other kind of problem with the geography
of their skin. So if it's not totally flat like six-pack abs and that sort of thing,
some people may find that the flexibility and comfort of a one-piece system is more preferred
over the two-piece system, especially when you're talking about a system like the Coloplast
Sensura Mio, which happen to have a very flexible wafer. This honestly feels extremely
comfortable. There's no plastic there that you've got to worry about. Obviously, there's no flange there
so that's an option for someone who really wants to go after comfort. But having said that, as we get
onto the two-piece systems, I'll explain something that gets you kind of the best of both worlds. Now,
moving on to two-piece systems. Two-piece systems are extremely popular. I tend to use two-piece systems, although I also
use one-piece systems on occasion. But I find that two-piece systems, especially the ones with the mechanical
couplings, have far more advantages over any of the other types of systems, and I'll explain those to
you right now. So as you can see here I've got a couple of examples of two-piece systems. One of them
here is from Hollister and the other one is from Coloplast. Now from looking at the wafers they seem to
look pretty similar and there aren't too many differences. You can see here on the Coloplast
wafer belt tabs are actually on the wafer part, rather than the bag, which is pretty unique, but
I'll explain why. And on Hollister's, it's a very simplistic design, very minimalist. All you have
is the flange there and the belt tabs are actually going to be on the back of the bag. Now, why do both
manufacturers do that? Well for some people that have high output stomas, for example where their
bag fills up faster than they can empty it, the weight of their pouch might actually create issues
for them. So in some cases, and I know I've actually been next to another person in the hospital who
had a very high output stoma, and his bag would literally fall off of his stomach - it would
basically detach from his two-piece system and that was a pretty big problem for him. Now,
Coloplast has thought of a pretty ingenious way of correcting that without having to necessarily rely on
the belt tabs (because they're not foolproof) and on the Coloplast two-piece system, they actually
have a locking mechanism, so when you combine the wafer in the pouch you can actually snap this
little lock closed and that basically means this is not going to separate anymore. It is foolproof,
and it doesn't matter how much weight you have on there, the only thing it's going to be tugging
on is the baseplate part the wafer part and that's why they put the belt tabs there. Now both of these
products are examples of mechanical couplings. I do have another example here of a two-piece
system, but this does not use a mechanical coupling, it actually uses an adhesive based system. So for
products which have adhesive couplings, what you're basically looking at is one flat section that
usually has an adhesive and then you have another section here on the wafer part that allows the
adhesive to stick to it. So once you remove the liner, you basically stick these together. Now, the
advantage of doing that is the fact that when you're putting your wafer on you can make sure
that it's around your stoma properly, make sure there aren't too many big gaps or anything that
might need correcting. You can basically align your wafer properly now when you have a two-piece with
a mechanical coupling you just snap your bag on and you're good to go. With the adhesive coupling
you can do the same thing, but generally speaking once that bag is attached, you don't necessarily
want to take that off. Part of the problem with adhesive coupling systems,
and this is something that I've experienced and I know a lot of other people have experienced,
is that sometimes you might get a little tiny breach in the seal and that can create a leak.
Now, the leak won't happen under the wafer it'll actually happen between the bag and the wafer,
so that might be pretty inconvenient and that's why it's not recommended to pull that apart. Now, a
disadvantage with the two-piece with the adhesive coupling is the fact that you can't freely rotate
it the way you would with mechanical couplings Coloplast is the easiest to rotate
out of the box because that locking mechanism basically tightens the whole flange in place.
When that locking mechanism is detached, then you can actually rotate the bag pretty easily. With
something like the Hollister or ConvaTec or other brands, that's not as easy to rotate, although you
can still do it and I have a trick for doing that. what some people might just actually remove the
bag rotate it snap it back on and then you're good to go. Now, as with a one-piece system, the two-piece
system with the adhesive coupling is not a system you want to use if you like to "burp" your appliance. If
you like to burp your appliance on either the one-piece or the adhesive coupling two-piece I
would suggest either doing it from the bottom of the bag which can be a little risky or going with
something called the Osto EZ-Vent which is actually a product that you would attach to your
bag and it's basically a vent that you can open up gas and will escape, and then you close it up again.
so that might be one option if you like to burp your appliance or if you have a lot of gas that
isn't effectively being removed by that filter. As I mentioned, one-piece systems tend to be cheaper
than two-piece systems and unfortunately that definitely holds true. You have to buy wafers and
bags separately and that usually increases the cost by a few dollars. Certain adhesive coupling
products I find to be more expensive. I'm not sure why, you know there's less plastic there
so I don't know if it's just the adhesive that cost more or what, but it really depends
also on the brand that you're going with. Some brands are far more expensive than others. So
there you have it guys, that's the rundown, the differences between a one and a two-piece appliance.
Like I said, most of it is going to be a matter of preference. Some people are just used to wearing
a one-piece system because that's what they were wearing in the hospital. I actually went from one-piece
and transitioned into a two-piece, but as I mentioned, I do switch back and forth depending
on what accessories I have on at the time. Now one little thing that I have noticed, however, when I'm
wearing a two-piece system, that really bothers me about a one-piece system, is the fact that while a
two-piece system might be a little bit thicker because of that extra plastic on the flange I
find that that little gap of plastic acts almost like a stoma guard of sorts. So for example, if
you have any kind of impact and you're wearing a one-piece system there is literally nothing
protecting your stoma from that impact whereas when you're wearing a two-piece system with a
mechanical coupling there's at least a little bit of a buffer there so that anything that
hits or tries to hit will actually be hitting that plastic part rather than your stoma. So I find that
actually to be a big advantage when I'm on roller coasters and other such fun things like that, so
that's maybe one thing to keep in mind if that's a concern for you, but for most people you
probably don't have to worry about that. So tell me guys, are you a one-piece or a two-piece
user? Leave a comment in the section below and I'd love to hear your feedback on the different
appliances that you've personally tried. Until the next time, see in another video. Bye bye.