1.

Prepare Your Stoma

Next, it’s important to prepare your stoma for the best results. If you currently have a
pouching system on, take it off and empty your bag. Proceed to wash your hands
thoroughly and clean the area around your stoma. Remove any hair if necessary and
avoid using oil-based products or alcohol. Warm water is the best option. Make sure that
the skin around your stoma is completely dry before moving on to step three.

2. Use a Stoma Measuring Guide

Take your stoma measuring guide and find the closest marker for the size of your stoma.
You can start with previous measurements and adjust as needed. Place the stoma
measuring guide over your stoma to confirm the correct size. Make sure that your stoma
protrudes through the hole completely without too much surrounding skin showing.
There should be about a 1.5 – 3mm gap between your stoma and the edge of your
measuring guide.

3. Transfer to Your Wafer/Skin Barrier

Next, you’ll need to transfer the size to your wafer/skin barrier and cut it accordingly.
Simply place your measuring guide onto the wafer/skin barrier and use your pen or
marker to trace the hole in the center. Some people need to make the hole a little off-
center due to wounds or skin ailments, which is completely fine. Just make sure you
remain within the “maximin” cutting area to avoid adhesion problems. Make sure that
you use your wafer/skin barrier scissors to avoid damaging to the product.

4. Test, Adjust, Prep, and Apply

Place the cut barrier over your stoma to test the fit. If you need to make any adjustments do so
before removing the plastic backing. If all looks good, continue with your skin care routine and
apply the wafer/skin barrier.

There are different types of wafers/skin barriers available to choose from. You can try a few
options and see what you like best. Many people have certain preferences or use different
products depending on their activity. Some options include convex, accordion, moldable, pre-
cut, and cut-to-fit options. To determine which pouching system is right for you, talk to your
doctor about testing different options.

Challenges to Sizing Your Stoma

While sizing your stoma seems like it would be a fairly straightforward process, there are a few
challenges that can make things difficult. If you have any problems, or need further clarification,
always discuss with your doctor or ostomy nurse.

Loop Ostomies

If you have a loop ostomy, measuring your stoma using a pre-sized circular chart can be
difficult. Loop ostomies have two different openings, so they can’t be measured easily using
printed guides. Some people with loop ostomies suggest using a half circle, rather than a full
circle, on the measuring guide to measure each opening of the stoma separately.
Wafer/Skin Barrier Differences

The differences between wafers/skin barriers can also make sizing your stoma a challenge.
Sometimes they act differently when they’re worn vs. when you cut them. Certain brands can
swell after contact with fluid, requiring a larger size to prevent leakage. If you notice this, try to
accommodate about 10cm of space. However, since some barriers fit perfectly with your stoma,
only increase the size after you notice these issues.

Stoma Changes

The most common challenge to sizing your stoma is changes in size and shape. This is
completely normal, especially in cases of weight gain/loss or changes in physical appearance.

How to Care for the Skin Around Your Stoma

Aside from properly sizing your stoma, one of the best ways to ensure that you have a well-
fitting ostomy pouch system is to keep the peristomal skin healthy. By creating a good stoma
skin care routine, you’ll keep the surrounding area healthy create a stronger seal. It’s important
that the area is clean and completely dry. This helps to improve adhesion to the baseplate. If
you have hair on the skin that surrounds your stoma,