Convexity is a new type of flange or pouching system that is meant to address various ostomy-related issues including leakage. There are a number of factors that you must consider while selecting and using convexity. The most important things you must keep in mind are:
∙ Your selected convexing matches with the formation of your stoma
∙ Convexing matches with the skin and contours around the stoma
This article will describe the basic factors, range of the supplies, and the estimated risks associated with convexity
The stoma skin barrier and flanges are available in two forms
∙ Flat
∙ Convex
Flat: The flat skin barrier means that it will appear flat when you will observe it from the side. And bulges or protuberances of any type are not seen at the sticky part of the flange.
Convexity: Convexity has a little form of protuberances at the sticky part of the flange. Generally, the stoma is in the middle and placed just right above the skin level. And the bumps or creases around are contoured by the peristomal skin. In this situation, you can use a flat flange. And if the peristomal skin has less ability to contour the protrusion you can go for a convexity. The projection on the backside of the barrier produces pressure on the skin surrounding the stoma and it brings some changes in the stoma or peristomal characteristics. Convexity can be worn for a long time and it will help you to feel more secure.
How convexity can be helpful?
Convexity can be helpful in various aspects.
∙ Prevents leakage: It can prevent the leakage of the pouch due to the tension provided by pressure on the peristomal skin. This works in the situations when:
∙ Stoma doesn’t protrude properly
∙ Stoma is flush with the skin
When the opening of the stoma is emptied directly onto the skin
There are a lot of options to assist your pouching system. Some ranges of the convex have been mentioned below:
∙ Simple addition of a flange ring at the back of the barrier
∙ Integrated convexity (already built-in convexity)
∙ An insert that can be added onto the flange
The convex products also provide a number of ranges for protrusion such as light or deep. These differences enable a small level of changes for every person according to the condition of the stoma skin and contours.
Levels of convexity
Low level convexity can fix small issues like slight over tipping of stoma, small skin folds. Low-level supplies include the products such as:
∙ Eakin
∙ Adapt convex barriers or rings
∙ ConvaTec inserts
Medium levels of convexity help to solve more significant problems i.e. poorly protruding stomas, skin creases. Typically, it is integrated into the flange. Examples of medium convexity are:
∙ Hollister’s New Image convex appliances
∙ Coloplast’s Assura light convex
Deep level convexity offers the maximum degree of protrusions and it is used to solve the most difficult issues:
∙ Retracted or protruding stoma
∙ Stomas with gullies
Fat folds which droop over the stoma
Deep convex products are:
∙ Coloplast’s Assura regular convexity
∙ ConvaTec’s Convex-It
However many people use deep integrated convex flanges to solve their issues, sometimes, barrier rings can also, be used along with these appliances to enhance the deepness of the convexity.
Although convexity helps to solve the issue related to peristomal skin and contours it can also assist a person in many other calamities.
Alternatives for the convex flanges
The price of the convex barrier is normally high than the other accessories. But it can help you in a better way than a flat barrier because it can increase the wear time and helps to enhance the seal. With the passage of time, it can be altered with any cheap product. It is recommended to replace the barrier rings with integrated convexity because rings are also very costly. Sometimes you can use products with mixed properties, this will provide better sealing, but it is important that those products match your flange. For example, you can use ConvaTec’s convex inserts only with the Natura -Sur Fit and Autolok flat barriers. You can seek help from your ET nurse to choose the best one for you.
Risks
Convexity may harm the peristomal skin. If you will apply too much convexity it will bring the risks of pressure ulcers in the skin, making the pouching system more complex, leading to pain, and you may require an ET nurse for regular checkups and care. Though pressure ulcers are not very common,, it is important to avoid too much convexity. Patients with IBD have chances to develop a skin pathology referred to as pyoderma gangrenosum (PG). It is an extremely painful situation that gives a clue of purple color pustules and then develops into an open ulcer. PG is caused due to any trauma or too much convexity. It can be cured with medicines. The alteration of the pouching system is needed in the case of PG. You can consult your ET to prevent any kind of skin issues associated with the pouching system.
If you have been using the wrong or incorrect size barrier or opening this may also develop the chances of lacerations (Cuts) to the stoma. The mouth of the barrier must be 1/8 inch or 3-4 mm larger than the stomal base. If you are using a flange with the same size as the flange and the stoma, the rigidity due to the convexity can touch the stoma, leading to a cut. It is possible that you may remain unaware of the cut, because it doesn’t bring pain, but you might observe the stomal bleeding.
Final Thoughts
Mostly the people with a stoma use convex appliances. ET’s may recommend these products to solve the issue related to peristomal skin and contours. As you know there are several products it is important to have information about your stoma in order to get the best option. You should observe the condition of your stoma and skin when you are sitting not while you are lying on your back. The sitting posture helps the ET to observe the peristomal skin in a better way. You may need to roll over the side to side and lift your legs up, and bend forward, all these positions helps the ET to choose the best product for you.
Convexity might be considered as the best option to help you with your pouching. After a proper assessment of your ET nurse can help you to choose the best option from the vast variety of these products.