Changing Ostomy Pouch

By Mary Lou Boyer, BS Ed, RN, ET, WOC Nurse Specialist

  • Gather supplies. (If you know your stoma size, prepare the barrier opening to the correct size. If not, measure and prepare opening at Step # 5 or # 6)
  • Empty the old pouch before removing it.
    • Helps prevent spilling stool or urine during pouch change procedure
  • Remove old pouch by holding an edge of the pouch and pressing the skin away from adhesive.
    • Pulling or ripping it off can cause damage to the skin.
    • You may need adhesive remover to help loosen the seal.
  • Gently clean skin around stoma with mild soap and water, or just water.
    • Do not use soap with creams or oil as this leaves oily residue on the skin and prevents pouch from sticking well.
    • Deodorant soaps can be too drying for the skin.
    • Adhesive removers can help remove stubborn or sticky residue.
  • Make sureany soap is rinsed off well.
  • Be sure skin is completely dry before putting new pouch on.
    • You may need to keep a dry cloth, some gauze or toilet paper right under the stoma to catch drips.
  • Remove protective paper from pouch/wafer barrier that sticks to the skin.
  • Remove protective paper from tape border or fold back an edge of the paper on the tape border so you can get hold of it easier to remove after applying wafer.
  • Center the opening of the pouch or wafer over the stoma and press firmly to seal the sticky barrier wafer to the skin.
    • Press at the lower edge to seal that area first and work your way aroundand up.
    • If using a two-piece system, you may apply the pouch to the wafer before starting procedure or apply now by pressing pouch onto wafer.
  • Close the bottom of the pouch using clip or integrated closure for open-end pouch. Close spout if using a urinary pouch.