Regular versus Extended Wear Barriers

There are various types of barriers readily available for people with ostomies. In addition, provision for ostomy products occurs in a range of wafers or barriers. Coming up with an idea of choosing the ideal barriers for a given type of stoma relies upon the required or desired appliance frequency changes, cost, and stoma drainage characteristic (liquid versus formed; volume fecal versus urine).

Perfect barriers should.

• Have a provision for secure/safe seal

• Protect peristomal skin against urine or feces

• Cost-effective with proper stoma management

• Should be gentle to the skin, especially in the process of flange removal

The composition of skin barriers includes various materials, including pectin, gelatin, karaya, and other synthetic materials. Several adhesive formulations are also added to the barriers to provide enduring adhesion and for initial tack. The precise formulation of the barriers will vary based on the manufacturer. However, regardless of the differences in the supplies, the set barrier principles apply in the selection. 

Typically, there is less resistance to liquid urine or stool for regular wear barriers. The wear-times for regular wear barrier for urostomies or ileostomies should be between 3-4 days). The type, as mentioned earlier, of barriers tends to melt, especially when exposed to stool or liquid (and mainly the high frequency/volumes of stool or urine movement), calling upon for unwanted peristomal skin exposure and the possibility of skin irritation, especially if left for quite some time. 

Regular wear barriers are ideal for well-formed stool, such as the one found with colostomies. Because the stool has less liquid content and less functioning of the stoma, a regular wear barrier will have achieved longevity of up to 5-7 days. Tack and adhesion tend to be slightly less with regular wear barriers since it provides a secure seal that allows frequent changes if needed without any damage caused to the skin. 

On the other hand, extended barriers developed to offer higher resistance to liquid urine and stool. Therefore, longer wear times with extended wear barriers are more realistic. Some of these products contain different substances known to be hygroscopic since they can absorb moisture originating from urine or stool, making the barrier swell around the stoma. This swelling action creates a provision for an ideal seal and resists stool weakening or urine under flange. 

The barrier movement will lead to normal peristalsis and stoma; it will not block or occlude the stoma opening. There is a tendency for more outstanding adhesion and track with extended wearable products. The advantage of these adhesions is that they assist with extended longer wear times. Great care is to prevent peristomal skin damage during flange removal. Extended wear barriers are ideal for people with urostomies or ileostomies. Simply because they will have them for longer times for about seven days, for people known to have liquid stool associated with colostomies, they should consider extended wear barriers.

The cost aspect should be put into consideration when factoring in the ideal barrier type. The extended wear barrier type tends to be quite expensive. However, the choice should be associated with the frequency of the flange changes, which tends to be somewhat less with extended wear barriers. 

On the other hand, if there is proper protection to peristomal skin with extended wear products, skin irritation is avoided, which helps eliminate additional products and accessories like powder. In addition, some of the products may be readily available as extended wear barriers.

The decision upon the melt-out degree determines the appropriate barrier and the time barrier is worn; it should factor the peristomal skin condition with the given appliance change.