Safe ostomy care

If you look through the right window at the B. Braun offices in Southwest France, you can see the Atlantic Ocean and the peaks of the Pyrenees, although Sergio’s head is somewhere else entirely right now. In front of him are seventeen different ostomy bags and two baseplates. Sergio is a project leader in the research and development department at B. Braun Medical in Saint-Jean-de-Luz. In this small community in the Basque Country, thirty-five million stoma bags and baseplates are manufactured every year for people who need to collect urine or stools by large or small bags: urostomy, colostomy and ileostomy bags. ​

“These people’s lives have been completely turned upside down by this ostomy surgery. They now have an artificial opening in their bodies,” says Sergio, using a plastic doll to show what these surgically created stoma look like: small, large, convex, concave. “Stool or urine just flows out of here, the patient has no control” says Sergio. The ostomy bag absolutely needs to work all the time. They must remain sealed, adhere well to the skin and never allow fluid or odor to leak. “That would be the worst case, it simply can't be allowed to happen,” says Sergio.​

He's been doing this job for almost twenty years. The heart of his work at B. Braun has always been the same. Ostomy users need to feel comfortable. In one of his first projects, the plastics engineer worked on a powder that turns the stool inside the bag into a gel, to make the contents more comfortable for users to carry. Since then, Sergio has led numerous projects, including designing filters with semipermeable membranes and activated carbon that allow gases, but not odors, to escape—without expanding the bag. He also developed an new range using on adhesive that is extremely gentle on the skin, and engineered special taps for draining the bag. In other words, users should not worry about unpleasant odors, noticeable sounds, open skin lesions or uncomfortable situations in their day-to-day lives. “Our work is always centered around people. I’m fully aware of this responsibility, as is every single person who works here,” says Sergio. Users of ostomy products need to count on Sergio and the R&D team because they must be able to count on their bags—every second of the day and every minute of the night. ​

Improvement through communication and feedback

Sergio meets regularly with ostomy nurses about the needs of ostomy users. “Ostomy nurses have a much better idea of what life is like for people with an ostomy,” says Sergio. These conversations have revealed, for example, that many users have trouble sleeping through the night. Some of them constantly need to get up to drain their bag. This led R&D team to develop some years ago a two-liter collection bag with a long drain line to connect to the ostomy bag.

This is just one of many examples, there are more than hundred different types of bags and baseplates. With or without drain, depending on how liquid the stools are and how limited their mobility is. Or, convex designs that fit better around folds, scars or a recessed ostomy, or with extra-soft adhesive for sensitive skin. One-piece or two-piece systems with baseplates so the bag can be better positioned, and urine collection bags designed for nighttime use, along with various connections. Even the color and material can be chosen: For ostomy nurses, it is important to see what is in the bag—users themselves may not always want to see the contents. “An ostomy can also have a psychological impact. We can't forget that,” emphasizes Sergio.

In the ostomy bag development lab​

“Every project starts here,” Sergio says. His dark blue pants and striped sweater are covered by a white protective gown. Sergio is standing in one of several labs in the research and development department, which is accessed through a glass-walled corridor with wood floors. Spatulas are ready for use. In one corner is a small hotplate for heating the adhesive, so it is easier to remove. White plastic containers marked “hydrocolloids” are placed under a table, various designs for flower-shaped protective skin barriers can be seen on laminated paper. It looks like the production facility in miniature. “Once the first attempts are good enough, they go to the bigger machines,” says Sergio. The R&D department is responsible for continuously improving products, coming up with new ones, and maintaining the high quality of current ones. “The goal is always to protect the peristomal skin and that the seal stays intact,” he says. Sergio remembers one time a very passionate nurse took a bag and stomped around on it to make sure her ostomy users have nothing to worry about. Although the bag was not designed to be stepped on, the seal held.

The responsibility Sergio and the R&D team bear always requires a very precise balancing act. The adhesive that connects the bag to the ostomy—the opening in the abdomen—must be sticky enough so everything stays attached and sealed. But not so sticky that it damages the skin. In short, it need to be strong enough to bear the weight of the bag, weak enough to be removed from the skin without causing damages. Skin is a natural material. It can be dry or moist, loose or firm—it changes depending on nutrition, age, environment, and others.

The R&D team has developed several special formulas for the skin adhesives. It's a hydrocolloid material that absorbs sweat, while remaining sticky and adapting to the skin. “We're specialists in the recipe for this adhesive,” says Sergio. The expertise behind this B. Braun specialty has been well earned by the R&D team, these are recipes that have been created over countless hours of work, experiments and discussions. “I enjoy it,” says Sergio. He says that developing products is always interesting for engineers like him, naturally. He thinks he would also have fun doing it in other fields, though being able to create something that can really improves people’s lives is something else entirely—much more fulfilling. It's about people's everyday lives. About life. “The success I’ve had here in the last twenty years can lead to improve quality of life for our ostomy users, and that makes me proud,” he says.​

In the meantime, ostomy bags are being manufactured on the upper production floor. Rolls of plastic film and nonwoven fabric are everywhere, the assembly lines are humming. Toward the end of Production Line 6, a machine uses suction cups to lift two finished ileostomy bags up and places them cleanly on two stacks of ten. The line continues to work down to the end, where a worker in protective clothing counts off thirty bags with an experienced hand, checks them one last time for production defects, then packs the stack into a B. Braun cardboard box. First the bags, then the filter stickers, and finally, she reaches for another sticker roll. A sticker is then placed on each box, stating “More than 50 years of experience in ostomy devices and skin devices—made in France.” It's more than just a label on the box, it's a promise. “Our users want to live their lives without worrying that something will leak out,” says Sergio. “We want to help them with this.”