Key Takeaways

• Convex ostomy barriers: Gentle outward pressure helps protrude flush or retracted stomas, improving the seal between the skin barrier and peristomal surface, reducing leakage, protecting peristomal skin, and extending pouch wear time.
• Clinical assessment: Base convexity selection on stoma characteristics, abdominal contours, and peristomal skin, using evidence-based consensus guidelines rather than a one-size-fits-all approach.
• Patient management: Consider early convexity for flat/retracted stomas, ongoing leakage, or uneven peristomal surfaces; monitor pouch fit and wear time, and educate patients to recognize complications and participate in care decisions.

Please note: This content is a direct transcript, capturing the authentic conversation without edits. Some language may reflect the flow of live discussion rather than polished text. 

Transcript

Hi, I'm Alex Aningalan. I'm currently the program manager for New York Presbyterian at NYP Westchester.

Convexity provides gentle outward pressure around the stoma, which helps in protruding a flush or attracted stoma and creates a more secure seal between the skin barrier and the peristomal surface. This improved seal reduces leakage, which directly lowers the risk of peristomal skin damage and reduces the incidence of pouching system leakage. As a result, patients experience fewer complications and improved pouching system wear time, which are actually key factors that support confidence and independence. Ultimately, convexity can significantly enhance the quality of life by allowing patients to engage actively in daily and social activities without fear of leakage. 

I would say start with a thorough assessment of the stoma characteristics, abdominal contours, and peristomal skin, and to match the level of convexity to the patient's specific needs rather than defaulting to just one type. Also, utilize current evidence-based consensus guidelines to guide you in selecting the appropriate type of convex barriers. Moreover, it's important to introduce convexity early when indicated, especially for patients with flat or retracted stomas, or patients with ongoing leakage or complicated and uneven peristomal surfaces. It's also essential to monitor closely after initiation of your pouching system. Providers should check pouching system fit and wear time, and most importantly, educate patients on what to expect, how to recognize early signs of complications, and how to participate in decision-making so the approach remains both effective and patient-centered.