Use of Convexity in Pouching

Abstract

A comprehensive literature review was conducted to examine research, current best evidence, and best practice recommendations associated with the use of convex skin barriers for patients living with an ostomy. The review revealed a fragmented array of citations related to convexity and a paucity of evidence regarding convexity product descriptions and application. Most convexity choices appear to be based on the clinician experience over time using trial and error to determine clinical application. Current descriptors used for convexity products are creating confusion, and a standardized approach to product nomenclature does not exist. The development of assistive clinical practice guidelines, in conjunction with further research, is recommended.

Use of Convexity in Ostomy Care

“…Convexity is defined as A curvature on the skin side of the barrier or accessory. 2 Convex products are frequently cited as the preferred means to manage flat or retracted stomas and to compensate for irregular peristomal planes such as creases or folds. 1 , 3 – 7 Although a variety of convex products are available with different depths and shapes, there is little supporting evidence to guide their selection and use.…”

“…1 , 3 – 7 Although a variety of convex products are available with different depths and shapes, there is little supporting evidence to guide their selection and use. 2 …”

“… 6 , 8 , 9 During the 1980s and early 1990s, multiple ostomy product manufacturers designed and released firm convex skin barriers designed for both 1- and 2-piece pouching systems. 2 More recently, manufacturers have introduced additional accessories with convex features such as barrier rings and soft convex skin barriers. 2 …”

“… 2 More recently, manufacturers have introduced additional accessories with convex features such as barrier rings and soft convex skin barriers. 2 …”

A Novel Use for Botulinum Toxin A in the Management of Ileostomy and Urostomy Leaks

“…In many instances, these problems respond to appliance changes such as application of a convex pouching system that can effectively lengthen a stoma to avoid leaks or use of accessories such as paste or barrier rings to level an irregular surface. 2 However, we see a number of patients with recurrent leaks and pouching system failures who do not respond to pouching system modifi cations. In some of these cases, pouching system problems appear to be the result of a particularly contractile stoma that rhythmically shortens, to or below the level of the skin surface, and effl uent may eject sideways so that it rapidly degrades the bag adhesion, resulting in leaks as illustrated in Figure 1 .…”