Stoma Care - Two Piece System (Mouldable Wafer With a Clipless Closure Bag)

Step-by-step guides by NUH stoma nurse on how to (1) change and (2) empty bodily discharges from the two-piece system stoma bag (mouldable wafer with a clipless closure bag).

Steps to change two-piece system stoma bag:
1. Wash your hands with soap and dry it with a clean towel before changing the bag to prevent infection.
2. Gather all the equipment required.
3. Gently remove the wafer by peeling from the top to the bottom, with one hand pressing against the skin.
4. Dispose of the soiled bag. To re-use the bag, wash it with soap and water and let it dry before using the bag again.
5. Clean the stoma and surrounding skin with paper towel wet with tap water. Remember to clean off any bodily fluids, stools and adhesive stains. Then, use a fresh paper towel to dry the stoma and its surrounding skin.
6. Mould the wafer opening to make it about 3mm larger than your stoma.
7. Apply moisturiser to the rim of wafer.
8. Remove the inner protective backing from the wafer.
9. Apply stoma paste or stoma ring evenly at the back of wafer. Alternatively, you can apply the stoma ring around the stoma.
10. Apply the wafer over the stoma gently and ensure it sticks well to your skin and does not leak.
11. Remove the outer protective backing from the wafer.
12. Dust some stoma powder around the stoma.
13. Clip the bag to the wafer at 45 degrees, which is a lying position or 90 degrees which is a standing position to the body.
14. Fold up the outlet and press the interlocking closure together.
15. Turn the “lock it pocket” outside in. Hide the tail inside the pocket.
16. Wash your hands with soap after you have changed the stoma bag

Steps on how to empty your stoma bag:
1. Reverse the “lock it pocket” to reveal the tail.
2. Unlock the inter-locking closure by lifting at the corner and unravelling all the folds.
3. To make draining easier, open the tail end by pushing in both ends of the outlet end strips with your thumb and forefinger.
4. Position the opening of stoma bag facing downwards, and then drain the stools into plastic bag or toilet bowl.
5. Clean the outlet with a wet paper towel. Then, fold back the outlet after dabbing it dry with a fresh paper towel.
6. Wash your hands with soap after you have emptied the stoma bag.

Tips to keep stoma in good condition:
- Do not pour water into the stoma bag for washing while attached on body.
- Bathe either with or without the stoma appliances attached to the body.
- Place a cushion to protect your stoma when wearing a seat belt.
- Bring along some extra stoma appliances when going out.

00:00 – Introduction
00:13 – What is mouldable wafer with clipless closure bag
00:41 – Steps on how to change the mouldable wafer with clipless closure bag
03:15 – Steps on how to empty stoma bag
04:17 – Tips to keep stoma bag in good condition

Watch Stoma – Types of Stoma and Living with a Stoma Bag https://youtu.be/YtwaMyK56ss
Watch Stoma Care – One Piece System (Wafer with Open Ended Stoma Bag) https://youtu.be/VHjUH7yXiJU
Watch Stoma Care – Two Piece System (Cutting Base Plate with Open-Ended Stoma Bag) https://youtu.be/wFKh-CyznJU

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NUH is Singapore's major tertiary hospital and referral centre with over 50 medical, surgical and dental specialties. It is the only public hospital in Singapore to offer a comprehensive suite of specialist care for adults, women and children as well as paediatric kidney and liver transplant programme, in addition to kidney, liver and pancreas transplantations for adults.

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  Stoma Bag