A Mini Guide to Ostomy Supplies: Wafers (w/ Video)

Ostomy Wafers

Video

Mini Guide to Ostomy Supplies: Ostomy Wafers
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What Are Ostomy Wafers?

A wafer is the part of the ostomy appliance that sticks to your skin.  

Wafers can also be referred to as a baseplate, skin barriers or a flange, although “flange” is more commonly used to refer to the coupling component that you attach the bag to on a two-piece system, and skin barriers are more likely to be associated with barrier wipes/sprays or even barrier rings.

Ostomy appliances come in two distinct styles: one-piece and two-piece.  I explain in detail the differences in THIS article. In short: one-piece appliances include a wafer and pouch, while in two-piece systems, the pouch and wafers are separate and can be purchased independently.


Extended and Regular Wear

Manufacturers have their own unique style of wafers, and adhesives can vary from “normal wear” to “extended wear”. 

Wafers are designed to be worn between 1-7 days (depending on many factors), but many ostomates can get around 3-5 days of wear if there are no problems.

Ileostomates and Urostomates may want to use “extended wear” products, as they are designed to better handle aggressive liquid output better than “regular wear” can.

If you are a colostomate or someone who uses a closed-ended pouch that is replaced every day or multiple times a day, you may find that “regular wear” wafers are easier to remove and more gentle on the skin.

The flexibility of a wafer can also range from semi-rigid (i.e. Coloplast Assura) to extremely flexible (i.e Cymed Microskin), and they can be made using anything from hydrocolloid to tape and even thin films; some wafers have a bit of elasticity to them, which allows the wearer to bend more easily.

One thing to note, however, is that the center of the wafer is most often made of a material that absorbs moisture (like hydrocolloid), even though the borders can use other materials.

Coloplast Sensura Xpro front
Coloplast Sensura Xpro wafer (front); note the belt loops on each side of the flange.
Coloplast Sensura Xpro back
Coloplast Sensura Xpro wafer (back)
Hollister CeraPlus wafer front
Hollister CeraPlus wafer (front); note the tape border; note that the belt loops aren’t on this wafer, but they are on the pouch.
Hollister CeraPlus wafer back
Hollister CeraPlus wafer (back)

Flat vs. Convex

Wafers will come in different sizes and thicknesses depending on the size or shape of the stoma that needs to fit through it; pediatric wafers and appliances are also available for infants and children.

The adhesive part of the wafer can either be flat or convex; convexity works better for ostomates who have a flush or recessed stoma since it applies gentle pressure around the skin and often reduce or prevent leaks in those situations.

Convex Wafer
An example of a convex wafer. Note the bulge on the bottom half.Photo: Courtesy of The Front Butt YouTuber

Pre-cut, cut-to-fit, or moldable?

Wafers can either come pre-cut to the size of your stoma, cut-to-fit or in a moldable option.

For a cut-to-fit product, you have to measure your stoma and cut a hole of the same shape/circumference into your wafer. An advantage of using a cut-to-fit is that you’ll be able to better size your stoma if it’s irregular or has a tendency to change size (common after surgery).

The moldable option, allows you to stretch a hole to fit your stoma into, and then allows you to mold it to form around your stoma; moldable wafers can often replace barrier rings for leak prevention.

convatec moldable
The ConvaTec moldable wafer hugs around the stoma for a nice fit.

Other Types of Wafers

I will briefly mention two other types of wafers, that are far less common but are still being used by some ostomates: non-adhesive wafers and reusable wafers.

  • Non-adhesive wafers.  The company Nu-Hope offers a non-adhesive system. Info can be found HERE.
  • Reusable appliances.  Perma-Type carries a reusable, rubber ostomy appliance that can last up to 3 months (with wear-time ranging from 3 days to up to 3 weeks!) and is adhered to your skin using “surgical cement”.  More info can be found HERE.

How Ostomy Wafers Are Usually Sold

Wafers are sold in boxes of either 5 or 10 per box. Some brands individually seal each wafer (like Hollister and ConvaTec), however, I don’t find that this makes any difference to the “freshness” of the product.

Wafers are one of the most expensive components of an ostomy appliance system.  In Canada, wafers are sold between  $40 and $70 per box of 5, with convex appliances being sold in the higher range.  All insurance plans that cover ostomy supplies would include wafers as part of their coverage.

Purchase on Amazon

You can purchase ostomy wafers on Amazon (affiliate links): USA | CANADA


How to Use an Ostomy Wafer

An ostomate will apply a wafer to their skin after a hole is made in the center of the wafer to fit their stoma through.  As mentioned previously, some wafers are pre-cut, so they can be applied without any modification.

Most wafers are heat and/or pressure-sensitive, so they will stick better to skin when they are warmed up before applying them and pressed onto the skin for 60 seconds or more; some ostomates will rub the wafer between their hands to warm it up, and others will put the wafer under their armpit or they may use a hairdryer.  

There is no proper way to heat a wafer up, but use caution not to burn or melt them (i.e. by putting them on a baseboard heater).

Here’s a video of an appliance change where you can see how I remove and apply my wafer.

How to Change Your Ostomy Bag: Ostomy Care Tips
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When it comes time to remove your wafer, it can be as simple as gently peeling it away from your skin, although I recommend the use of adhesive remover products if peeling it is difficult or causes irritation. You can find out more about them HERE.


Tips When Using Wafers

  • Burning or itching under the wafer is often a sign that you need to change it.
  • Shave the skin around your stoma to allow the wafer to stick better.
  • Adhesive remover products can help to ease appliance removal or to help clean up adhesive residue left over by the wafer.
  • Try different wafers to see which one is best suited to your skin, body shape, and activity level.
  • I always inspect the back of my wafer after removing it to see how much erosion took place; if I notice a problem, I can correct it on the next appliance change.
  • Two-piece wafers will sometimes come with loops to attach an accessory belt to; some systems will have these loops attached to the pouch instead of the wafer.
Close up of belt loop.
Close up of belt loop.

Are Wafers Vegan-Friendly?

There are many brands that contain gelatin, but you can also find wafers that are free of animal ingredients. I have a list of those products on the vegan/non-vegan supplies page.


Additional Resources

I’ve reviewed several brands of wafers, and I’m always trying new ones! You can find the published reviews HERE.

16 thoughts on “A Mini Guide to Ostomy Supplies: Wafers (w/ Video)”

  1. Heat and pressure.  A support belt helps too, especially if you’re in a hurry.  I’ve had to do a quick change right before leaving for work.  Stealth belt works wonders.

    Reply
  2. Hi Will, I second everything Eric has said. A little heat seems to wake the glue up. I will use a hair dryer to gently warm up the wafer and also to make sure that the skin is completely dry. Wrap the stoma up with some gauze as it keeps moisture from it away from the skin. Just mind not to over heat the wafer. Don’t overthink and less is more 👍

    Reply
  3. Do any of the adhesives actually increase the adhesiveness between wafer and skin. I often need several attempts to get a one piece bag to adhere. Related questions are 1) which type of adhesive is proven more efficacious increasing adhesion to skin? 2) Immediately after surgery when nurses were changing bags I rarely had any issues with leakage despite the fact that all that was ever used was a skin barrier wipe ( sure-prep) and the adhesive that was part of the wafer as sold no pastes to fill crevices were used nor were additional glue aside from that which was already on wafer. I’d truly appreciate any help with this as this problem is increasingly aggravating.

    When going through the process of a change that requires up to 6 attempts, asking gets more sensitive & inflamed then when changing it after times when bag lasts recommended 4 days or so. The glue/paste that I’ve been using is more difficult to remove when adhesives/fillers have insufficient time to cure. After 4 days they are usually easily removed as the have hardened but w/o sufficient time they remain gluey and are far more difficult for me to render clean causing further skin irritation.
    One way that would seem to increase adhesion is to increase surface area of wafer size. This would seem to allow a greater amount of glue and degree of adhesion. This is esp. true with the convex wafers some of which are tulip shaped decreasing surface area ever more.

    Thank for any time and consideration.

    Reply
    • Hi Will,

      I do not use a separate adhesive product, and find that with the proper technique, I’m able to get the wafer’s own adhesive to stick very well without any extra products.

      First thing to note is that “regular wear" and “extended wear" wafers will give you different wear time, with the latter having a more aggressive adhesive.

      Anecdotally, I find that the larger surface area of a 1pc does help with keeping the bag on for longer. For one, it mitigates any tugging that comes as a result of the bag filling up. And having that much adhesive just provides more time for it to peel off on its own.

      Some 1pc appliances, however, might exacerbate wrinkles in the wafer caused by folds in the skin, bending, etc. This can be where a smaller wafer could work better.

      Some skin preps can actually interfere with adhesives, so I don’t tend to use those, either.

      For me, a combination of heat and pressure on the wafer at the time of an appliance change is what helps me the most. If I were to take a hot shower after putting on a wafer, the adhesive turns to super glue! You can have a similar effect by warming the wafer before applying it.

      I hope this helps.

      Reply

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