Flange size question

[pete19382]

Folks,

Another question for the board tonight. My wife came home with 2.25" flange supplies, but I know they are also available in 1.75" (among others.) Is there a general rule of thumb to decide whether 2.25" is ideal and not just the "standard" that everyone comes home with? Is the overall wafer smaller with a 1.75" flange, or do they just end up with a larger percentage of adhesive area? Any disadvantage to the smaller flange?

Thanks folks,
Pete

[Mara]

Perfect timing as I just received an order of supplies!!

My flange size is 1 3/4" which measures basically from the center where the stoma will go to the edge of the flange which includes the adhesive area...
This is the same type I have used for decades.

It is a Convatec Natura Sur-fit Stomahesive wafer and below is a link so you can see what I am talking about:
https://www.convatec.com/products/ostom ... in-barrier

Hope that helps!

[Mysticobra]

I use the same but with the wite tape.
That warns me when I do get a leak past the flange.
Once I see the leak in the tape I change. Not having the tape it would get on clothing or something else before I not e the leak.
I know some are allergic to the tape . And it takes some getting used to.
I don't know my size. I'd have to go look. Which I will and add later.
Richard.

[Mysticobra]

Mine are 1-3/4. With pre-cut holes of 45mm. Plus the addition of the white tape. Which is about a half inch or less. Didn't measure the tape.
Richard.

[patrimo]

Hi Pete,
In answer to your question:

Is there a general rule of thumb to decide whether 2.25" is ideal and not just the "standard" that everyone comes home with? Is the overall wafer smaller with a 1.75" flange, or do they just end up with a larger percentage of adhesive area? Any disadvantage to the smaller flange?

From the vegan ostomy site (I do love this guy. He has a wealth of great information on his site):

Another thing about wafers is that they come in all kinds of sizes and materials. When I buy wafers, I try to get a size that allows for about 10cm of space between my stoma and the edge of the cutting lines (or up to the flange ring on my 2pc system).

If you use a wafer that doesn’t give you enough space, you may end up having difficulties cutting it, or worse, develop leaks.

There’s no harm in getting a wafer that larger than you need, and you may be able to get more pouch support because it has more surface area to stick to.

That is, of course, provided that a large wafer fits well on your skin (there is such thing as having a wafer on that’s too big!).

The article, with pics and videos (he's not afraid to show you what he's talking about, lol) is here:
https://www.veganostomy.ca/how-to-measure-stoma/

[bagboy]

Hi Pete,
I think the size of your, or your wife’s stoma will be the major factor in sizing your flange. Initially, at least for a colostomy stoma, your stoma will be a bit larger but with time should shrink down to whatever your personal size will be.
I came home from the hospital with some fairly large hollister gear initially, I can’t remember the exact size of my stoma right after the surgery but my SWAG for that would be probably around 40mm or so. My stoma has since settled down to more or less 25mm. I am currently using a coloplast 40mm flange and I am cutting a 25mm hole in said flange for my stoma.
I don’t see any advantage to using oversized hardware other than that is what you have it on hand.
Most stoma hardware manufacturers offer free samples and I would encourage you to take advantage of that. Different skin types, different body types, and different rates of “output” all add up to something slightly different being the best solution for each of us.
Hope that helps,
Mark

[pete19382]

Thanks all for the info.

I think vegan ostomy has a typo - I think he meant "10mm" when he said "10cm" - 10cm is almost 4 inches, which would make his overall wafer about 10"x10". Seems unlikely

Her stoma is just under an inch/25mm, so she's got lots of space between her stoma and the ring. The wafer itself is 4"x4", but we have to trim some off one side of it to avoid putting the adhesive on her still-healing incision. If using a 1/2" smaller ring means the wafer is now 3.5"x3.5", we could probably dodge having to trim the adhesive and have as much adhesive as we are supposed to. Can anyone using a Hollister 1.75" flange measure the wafer and give me the dimensions? (I can't find that info on the Hollister site.)

And Mark - I haven't looked at the Coloplast site. 40mm would be about 1.5". What is the wafer size for that one?

Thanks folks
Pete

[patrimo]

Hi again.

The Hollister New Image, 14705 wafer is about 7.5 cm (roughly 3 inches). With the (very soft, skin friendly) tape, it's 4". I have trimmed the tape with no adverse effect.

I'm sure you're right about the typo on Veganostomy's site.

[bagboy]

Hi Pete,
My coloplast flange is a size 40, that flange comes with a 10mm hole precut and lines every 5mm to assist you in cutting for your stoma, up to a max of 35mm sized stoma for this flange.
I thought that wafer was just another name for the flange, but rereading your question I am assuming you want to know the overall area of adhesive???
If that is your question, the 40mm flange has a slightly football shaped adhesive area, almost 110mm wide by 90mm tall. There is a small non-sticky tab that appears to be designed to be worn at the “top” but I wear the flange with the tab at the bottom.
I typically wear the flange for six days and remove the bag when I take my daily shower.
When I chose this system one of the main reasons I looked at Coloplast was the small flange size. Unless you are the big beltbuckle type why would you want a 60mm flange when you only have a 25mm stoma?
If your wife has an ileostomy more frequent flange changes might be recommended, your stoma nurse should be able to help you with timelines/targets for that.
Cheers,
Mark