"The physical make-up of the stoma may dictate the best support answer for the individual."
Dependable worry-free support for ostomy appliances and their attachments is paramount to everyone involved with ostomy wear and has become essential to the comfort and well-being of users whose personal health aids be worn securely and comfortably.
Each method (belts vs. tapes) has its advantages depending upon the individual. In many instances a combination of both forms of support is recommended - tape to prevent unwanted movement of body attachments - belts to support the added weight of pouch contents.
Here are some considerations which may help you to determine the best method of support. The type of ostomy surgery is of course a primary factor because it determines the stoma location and the equipment required to service the stoma. The physical make-up of the stoma may dictate the best support answer for that individual. Likewise, the amount of effluent is a factor. Physique and/or skin quality may also influence the choice of support. Certain physical activities must also be considered. Work or recreational activities (swimming vs. time spent at the office) will put their own unique demands on the body.
Potential problems in using a belt
One of the more common problems comes from wearing the belt too tight. This causes the elastic to become overextended which allows the elastic to curl, forming a rope-like fit (instead of flat fit) around the waist. This is uncomfortable and can lead to skin rash and soreness. The solution is simple - adjust the fit and tension of the belt or strap to be snug and comfortable to the wearer. Another problem is caused when the belt "rides up" on the waist or shifts off center, creating a pulling force on the appliance. The width of the belt as well as a proper tension around the waist will usually avoid this problem.
It pays to take a few minutes and go through some common body movements with the belt under load. Adjustments can be easily made at the inception and need not occur inconveniently later on during normal wearing time.
Baseplates with belt attachments have a larger lateral size than those without and can very often "dig in" causing skin sores.
Belt buckles can cause discomfort and irritation if they are not smooth and relatively small and flat. You have a choice of metal or plastic buckles. Some belts offer a combination of hook-and-eye plus Velcro closure. Proper belt width is very important. Different belt material is available and may also be tried. Materials like elasticized fiber or rubber offered by various manufactures may cause one belt brand to feel "hotter" than another. Again, the user should be the chooser!
Pluses for the belt
The belt provides extra support strength for greater weight loads. For example, the contents in a pouch for those who have had a urinary diversion can become quite significant as the weight changes. This weight build-up can create a pull on the abdominal wall and on the base plate of the appliance. A belt kept reasonably in line with the pouch will generally assure stability and support, regardless of the weight of the contents.
Stoma area protection under weight loads
Heavy pouch loads over long periods of time can lead to herniation at the stoma. This can (hopefully) be avoided by proper belt and appliance fit at the onset. If herniation problems occur or a weight support weakness is present, Nu-Hope has developed a special four-inch support belt made to accommodate such a problem. The 4" belt reinforces the adhesive seal to the skin. The circular opening of the support belt allows the pouch to fit through and rest securely, permitting the pouch to fill without restriction.
When belts are not practical, the alternate method is tape. Tape can be simply placed around the perimeter of the base plate or appliance seal. There are many kinds of tape: paper porous tape, all plastic tape (pink in color), and combination cloth and plastic tape. Nu-Hope pre cuts its combination cloth and plastic tape to fit the circumference of baseplates and pouches and is a standard accessory at Nu-Hope. Problems can occur with tape adherence when activities such as bathing or swimming take place. In this case, the all plastic tape is usually the best answer.
Proper tape application
Tapes should be placed fully around the appliances' seal to the body - half of the tape on the sealing base - half on the body. In time the user will find this application easy and become skilled at tape placement. A gentle rubbing and pressing-on with the fingertips is all that is needed.
Potential problems of the tape
Most problems with tape involve either irritation to the skin or the inability to provide a total and secure seal around the base plate or appliance. Skin irritation can come from allergic reaction to the tape adhesive. Frequently this irritation results from inadequate or improper preparation of the skin area prior to tape placement.
Proper preparation begins with proper removal of the used pouch or appliance from the skin. Very often skin irritation or soreness is caused by the frequency of changes and, most often, by impatient methods of removal. No one, especially the patient, likes to tear off tape from the skin! When the time comes to change the pouch or appliance, it should be removed gently. Do this by using your one hand to lift the appliance off while the other hand gently pushes away the skin. Nuisance or established bonds come off easy with Nu-Hope Cleaning Solvent which safely dissolves old adhesive and leaves skin adhesive free. Washing skin with soap and water is a must to eliminate oily residue and potential skin reactions.
We hope that Belts vs. Tapes will provide a better understanding for each and allows a choice that suits your everyday needs and special situations. There is always that universal problem however . . changes in body weight. Any excess weight gain or loss (5 to 10 lbs.) can change body contours and interfere with comfort and equipment efficiency for either tape or belt users! Who needs another reason for weight watching?