If there was ever an ostomy appliance that I really wanted to work for me, it would have to be the Cymed Micro Skin 2-piece appliance.

In this review, I’ll go over my experience with it based on products I’ve purchased from a local supplier.

Video

https://youtu.be/pN6XHxz80J8

About the Cymed 2pc Drainable System

Products I’ved used for this review:

Product name: 2pc drainable pouch with “Press ‘n Seal” closure; opaque.
Manufacturer: Cymed
Product #: 51445V
Dimensions: 11″ pouch
Quantity per box: 10
Product name: MicroSkin adhesive barrier; thick washer.
Manufacturer: Cymed
Product #: 78000
Dimensions: Cut to fit up to 45mm.
Quantity per box: 5

Cymed Microskin pouch package contents

Cymed Microskin wafer package contents

The wafers come in an envelope, but they end up sticking to each other.

Cymed is a small company out in Sacramento, California, and they are known for their MicroSkin line of ostomy products.

Their two-piece systems come in a few configurations: thick or thin “washers” (this is the part of the wafer that goes around your stoma; thicker is used for ileostomy output), drainable and closed options, and also velcro closure (“press ‘n seal”) or clips.

Now, the packaging for the wafers is different from what I expect from an ostomy appliance, and they come in an envelope of sorts – the pouches come in a box. The wafers, from what I can tell, aren’t going to be very easy to travel with because they tend to stick together and there’s nothing keeping them from getting messed up in a travel bag or because of heat.

One oddity I noticed is that there’s no expiry date on either package. Since we know that ostomy appliances do have a shelf life, and nearly every single product I’ve ever used has come with at least a manufacturer date, it seems very strange that it was omitted from the packaging.

Cymed Miroskin wafer package info

Cymed Miroskin wafers

Cymed microskin pouch package info

Cymed microskin pouches

The Wafer

What sets this appliance apart from the competition is the unique design of the wafer.

Unlike a traditional wafer, which is either made of hydrocolloid (thick) or tape (thin), the MicroSkin wafer is made of a transparent film, which does make it the thinnest I’ve seen on any ostomy appliance on the market today. Most people will find that it’s quite comfortable, very flexible, almost unnoticeable; it should fare well in water when swimming or when taking a shower, too.

While is it thin and flexible, I did notice that it would buckle where the “washer” and film meet, causing sharp edges to irritate my skin. You can see from the photo below that it looks pretty bad, but this was only a big problem once, and it wasn’t so bad on subsequent appliance changes.

Cymed Microskin skin irritation

Notice the redness under the harder part of the wafer?

Wear time is about average (assuming you don’t have leaks) and I would get a maximum of three days with these with very minimal erosion of the wafer.

The MicroSkin and pouch are supposed to hold up well in showers, and Cymed has marketed this product as something that you could take in water and even surfing, but I’ve experienced edge peeling after a few days. This is rather disappointing, and adding a wafer extender would defeat the purpose of having something this thin on your skin.

One of the troubles that I found with MicroSkin is the fact that you have to be absolutely precise when you’re applying both the wafer and pouch with the adhesive coupling; if there’s even the smallest little fold or buckling of the MicroSkin then your chances of having a leak are almost guaranteed.

This wouldn’t normally be such a huge problem with changing an appliance (although you should make sure that you’re putting it on properly), but this appliance requires many steps that can easily go wrong:

  1. Remove the release liner from the back of the MicroSkin wafer and “washer” (the center part).
  2. Apply wafer to skin.
  3. Remove additional release liner tabs from the back of the wafer and smooth out the MicroSkin.
  4. Remove another release liner on the face of the wafer (two halves).
  5. You then take your pouch and remove a release liner on that, which exposes an adhesive.
  6. Align the pouch so the adhesive portion sticks to a stiffer plastic – it’s best to start at the bottom and work your way up.
  7. Smoothen the appliance around the adhesive coupling to make sure there are no gaps or wrinkles (if there are, you need to start step 5 and 6 with a new pouch.

A tiny error on any of those steps can spell disaster with this product, and those steps didn’t include cutting the wafer, which has its own challenge because the wafers don’t have any kind of cutting guide circles on them. This means that even if you know the size of your stoma and just wanted to cut a hole for it, you wouldn’t be able to unless you had something to trace with or you were simply guessing and then applying it onto your skin to see if it actually fits.

Fortunately, Cymed does include a stoma measuring template in the package, but it creates an inconvenience for anyone looking to keep things simple.

A convex wafer is not sold by Cymed, but they do say the following:
Will a MicroSkin® pouch work with a recessed/flush stoma?
Yes, but we recommend plain MicroSkin skin barrier without a hydrocolloid washer/ring be used with flush/recessed stomas. When putting on the pouch, press down firmly on the plain barrier aroudn the stoma area to ensure no tiny air gaps remain that can lead to leakage after. Solid adhesion is crucial…
Cymedostomy.com

The Pouch

I had high expectations when it came to this ostomy bag, but they come with many flaws, in my opinion.

The pouch material is very flimsy and falls apart with gentle handling. I was hoping that it would be at least better than the Hollister New Image pouch material, but it is much worse.

Cymed Microskin pouches cheap material

Having a pouch material fall apart like this is not ok.

One thing that really has me concerned (and annoyed) is the fact that the opaque bags aren’t necessarily opaque. As you can see in the photo below you can tell exactly what the contents of my ostomy bag are, and you can also see it right at the bottom where the pouch outlet is!

Cymed opaque pouch not so opaque

Opaque? Yeah, not really.

Unfortunately, because of the way the pouch is designed, using this bag with a pouch cover isn’t as easy as it is with other two-piece systems which have mechanical couplings to keep the pouch cover in place. Not to say you can’t wear a pouch cover on this bag, it’s just not very reliable.

There is an inspection window on this bag, which can come in handy to see if your bag is full of gas or stool, and also to check on your stoma.

Cymed inspection window

At least there’s an inspection window.

The velcro end of the pouch is fairly easy to open, however, I found that the pouch outlet was really difficult to clean, and that’s mainly because only one side is stiff while the other side is just a very thin plastic. So unlike other products, the Cymed outlets are hard to actually open and keep open, and it seems quite flimsy when you’re trying to clean it the way I do.

The filter on the Cymed bag seemed to work pretty well, and I would say they are on par with the Hollister New Image filters, which in my opinion are one of the better ones out there. This isn’t too surprising as both manufacturers use a similar membrane to cover the filter and to keep it from clogging quickly. Unfortunately, because I wasn’t able to wear these bags consistently (due to leaks), I can’t really say how well they work long-term.

One selling feature of this product, which happens to be one of the only things that I like about the Cymed two-piece appliance, is the fact that it has a very low profile, unlike anything I’ve seen before.

Cymed low profile

That’s the wafer AND pouch! Really, really thin appliance.

My Experience

One of the things that I found to be most frustrating about using the Cymed system is that it is really difficult to get on and I found myself fumbling with the instructions several times, double and triple checking to make sure I got everything right, and finally putting the appliance on and checking it over and over again.

The thing that concerns me about having an appliance that’s so difficult to put on is the fact that I know there are many ostomates out there who may not have the same dexterity or fine motor skills as I do, so when they have to change it I fear they will probably have an even worse experience than I did.

The Cymed system also appears to be one of the most expensive that I found in Canada. The incentive to spend more money on this appliance isn’t really there for me, even if it worked without so many problems.

I did experience several leaks that came from the adhesive coupling, and I know that I had applied the coupling properly. It seems that bending created a fold in the wafer’s coupling which subsequently caused the product to leak.

Cymed microskin 2pc leak

This happened often :(

In one instance, I experienced a “catastrophic failure” of the appliance, which forced me to stop using them altogether. I woke up one morning and the bag was simply detached from the wafer. You can imagine the mess I woke up to because of it (it was the worst leak I’ve experienced to date).

I haven’t tried the one piece appliance that Cymed makes, but I suspect they’re a little easier to use mainly because the majority of the issues that I’ve had revolved around fiddling with the adhesive coupling.

Conclusion

At the time of this writing (Feb 2016), the Cymed system appears only to be sold in North America. Considering the high cost, I can’t imagine them being imported overseas. You can request samples through Cymed, and I would encourage you to do so before investing in a full box.

Pros
  • Comfortable.
  • Very thin (even when compared with 1pc systems).
  • Inspection window is a nice addition.
  • Velcro-like closures work fine.
  • The “washer” seems to hold up well with minimal erosion.
  • The filter should be better than most due to the Gortex membrane.
  • Free of animal ingredients.
  • A stoma measuring guide is included in the box.
Cons
  • Can be quite difficult to apply wafer.
  • Adhesive coupling is prone to leaks.
  • Pouch fabric is terrible and not very opaque!
  • You can’t tuck the outlet under the cloth cover (stool is clearly visible).
  • Can’t use pouch covers reliably.
  • No cutting guide on the wafer.
  • Wafers don’t travel well and are prone to sticking to one another in the package.
  • Edges peel quickly.
  • Expensive.
  • Only sold in North America.
Not Recommended

Based on my experience, I couldn’t possibly recommend this product because it’s just too inconvenient to use, and it fails in some key areas. The useless opaqueness of these bags really does bother me, and I would feel uncomfortable with people seeing the contents of my bag because of that.

Despite the leaks and appliance failures I’ve experienced, I know there are people out there that haven’t had the same trouble with this system (at least, I think there are!).

For more information, please visit the Cymed Ostomy Co. website at www.cymedostomy.com
Question: Have you tried this two-piece system? How did it work for you?