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Decrease the potential risk of stoma leakage 

Convex ostomy bags - a solution for your patients?

Stoma complications can occur within one month after surgery but also at a later stage.[1] Some of the contributing factors may be the stoma placement, its characteristics, fistula formation or a high liquid output.[1] When any of these obstacles arise, effluents may irritate the peristomal skin and even seep under the stoma wafer.[2] As a result, the adhesion of the device can be compromised, and the surrounding area may also be irritated.[3]

If your patient suffers from stoma leakage, a convex stoma appliance may solve the issue. You can determine whether it is suitable by assessing the type of stoma and the patient’s abdominal contours.

When should you suggest a convex stoma system?
Man with stoma bag on naked upper body with male nurse with gloves indicating him how to apply the bag

Convex appliances may be appropriate for[7]

  • Flush stoma: A stoma should be 2.5 cm in length, so the seal around the base of the stoma can work well. However, if a stoma sits at the level of the abdominal skin, it is considered flush.
  • Retracted stoma: A retracted stoma sits below the level of the skin. This may have been caused by a technical difficulty during surgery or by postoperative weight gain.
  • Telescoping stoma: Especially at night, when patients are supine, the telescoping stoma can slide towards or below skin level.
  • Poorly placed stoma: If a stoma was formed during an emergency surgery while the patient was supine or had a distended abdomen, the result may be not optimal.
  • Folds of peristomial skin: The skin may form canal-like folds that cause leakage.
  • Soft abdomen: An abdomen with weak muscle tone provides little support for the stoma, resulting in contours in the peristomal plane.
  • High-output stoma: When the stoma discharge exceeds 750 milliliters per day, the likelihood of leakage rises. The same applies if the output is of a rather liquid nature.

Liquid discharge has the potential to seep into smaller gaps in the skin more easily than formed stool and crosses the skin barrier faster, even with well-protruded stomas. In such cases, convex-shaped products can increase the wear time of the wafer.[2,11]

Gently sloping convexity
Illustration of the convex cross-section of a wafer with description
Illustration of convex stoma bag  applied around a stoma

Highlight product

Discover the new generation of soft convex stoma bags: Flexima® Active O' convex

“The Flexima® Active O’ convex has advantageously replaced the rigid convexity and offers a wider range of action. When convexity is needed, soft convexity is a good choice for me.”

Anne van der Drift, ET Nurse – Bichat Hospital, France

O' what a difference

Features and benefits of Flexima® Active O' convex

“When I use Flexima® Active O’ convex, I can rely on softness and my patients' chances of being protected from leakage increase.”

Virginie Lhommet, ET Nurse – Bichat Hospital, France

“In my experience, this bag is particularly suitable for stomas that are flat or slightly retracted. Especially if the stool is liquid, this can be used to avoid leakage and thus peristomal skin irritation. I recommend the product especially for active and sporty people who will choose this appliance for its softness, which is a key criteria for their daily activities and quality of life.”

Danièle Chaumier, ET Nurse, President of the French Association AFET

Product overview

Our offer of one-piece convex stoma bags

Side view of Flexima Active O' convex wafer of 6 mm depth
Side view of Flexima Active O' convex wafer of 4 mm depth

Our offer of two-piece convex stoma systems

Side view of Flexima 3S convex wafer of 6 mm depth
Side view of Flexima Key convex wafer of 4 mm depth
Proxima® 2+
Side view of Proxima 2 convex wafer of 8 mm depth
  1. Malik T, Lee MJ, Harikrishnan AB. The incidence of stoma related morbidity - a systematic review of randomised controlled trials. Ann R Coll Surg Engl. 2018 Sep;100(7):501-508. doi: 10.1308/rcsann.2018.0126. Epub 2018 Aug 16. PMID: 30112948; PMCID: PMC6214073.
  2. Evans M, White P. Selecting convexity to improve and maintain peristomal skin integrity. Br J Nurs. 2020 Sep 10;29(16):S8-S14. doi: 10.12968/bjon.2020.29.16.S8. PMID: 32901550
  3. Andersen NK, Trøjgaard P, Herschend NO, Størling ZM. Automated Assessment of Peristomal Skin Discoloration and Leakage Area Using Artificial Intelligence. Front Artif Intell. 2020 Sep 10;3:72. doi: 10.3389/frai.2020.00072. PMID: 33733189; PMCID: PMC7861335
  4. Rolls N, Yssing C, Bøgelund M, Håkan-Bloch J, de Fries Jensen L. Utilities associated with stoma-related complications: peristomal skin complications and leakages. J Med Econ. 2022 Jan-Dec;25(1):1005-1014. doi: 10.1080/13696998.2022.2101776. PMID: 35833520.
  5. Nafees B, Størling ZM, Hindsberger C, Lloyd A. The ostomy leak impact tool: development and validation of a new patient-reported tool to measure the burden of leakage in ostomy device users. Health Qual Life Outcomes. 2018 Dec 14;16(1):231. doi: 10.1186/s12955-018-1054-0. PMID: 30547808; PMCID: PMC6295083.
  6. Cronin E. A guide to the appropriate use of convex stoma care products. Gastrointestinal Nursing 2013; Vol. 6, No. 2. DOI: 10.12968/gasn.2008.6.2.28803. ISSN: 14795248
  7. Perrin A. Convex stoma appliances: an audit of stoma care nurses. Br J Nurs. 2016 Dec 8;25(22):S10-S15. doi: 10.12968/bjon.2016.25.22.S10. PMID: 27935354.
  8. Hoeflok J, Salvadalena G, Pridham S, Droste W, McNichol L, Gray M. Use of Convexity in Ostomy Care: Results of an International Consensus Meeting. J Wound Ostomy Continence Nurs. 2017 Jan/Feb;44(1):55-62. doi: 10.1097/WON.0000000000000291. PMID: 28002174; PMCID: PMC5266410.
  9. Turnbull GB. 2003. The Ostomy Files: The Convexity Controversy. Accessed November 1, 2022.
  10. Hoeflok J, Kittscha J, Purnell P. Use of convexity in pouching: a comprehensive review. J Wound Ostomy Continence Nurs. 2013 Sep-Oct;40(5):506-12. doi: 10.1097/WON.0b013e3182a219b7. PMID: 24448619.
  11. Richbourg L, Thorpe JM, Rapp CG. Difficulties experienced by the ostomate after hospital discharge. J Wound Ostomy Continence Nurs. 2007 Jan-Feb;34(1):70-9. doi: 10.1097/00152192-200701000-00011. PMID: 17228210.

* except for Proxima® 2+, which has one hooking position for the belt