A wafer is the part of the ostomy appliance that sticks to your skin. Wafers can also be referred to as a baseplates, 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.
Manufacturers have their own unique style of wafer, 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. 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.
Wafers will come in different sizes, depending on the size or shape of the stoma that needs to fit through it, and you can also find smaller wafers for use with 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.
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.
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 This Product Is Typically 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 to 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.
How to Use This Product
An ostomate will apply a wafer to their skin after 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.
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.
- Burning or itching under the wafer is often an 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.
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.
I’ve reviewed several brands of wafers, and I’m always trying new ones! You can find the published reviews HERE.