What are Flange Extenders?
– What uses do they have?
– Tape extenders or hydrocolloid extenders?
Some of my current favourite flange extenders:
– OstoFix Forty / OstoFix Eighty – OstoMart
– HydroFrame – CliniMed
– Brava Elastic Tape – Coloplast
– Secuplast Hydro Aloe – Salts
– Acubond Strips – Independence Products (added Feb 20th 2013)
Some other flange extenders
Fig 1:An illustrative example of a flange extender in-situ
Ostomy Flange Extenders are a relatively new product to the ostomy accessories scene having only gained popularity in the last few years which in turn has seen more and more companies bring out their own variations on the theme.
Sometimes also known as security frames the flange extender is a curved strip of tape or hydrocolloid which can be layered over the edge of your existing ostomy flange adhesive and stuck into place.
The flange extender can be used in two main ways. One is as an extra layer of adhesive security for your flange so you have the confidence that the product will stay in place and provide extra protection from leaks, even if the flange itself starts to lift off from the skin.
The flange extender provide a second layer of defence that is independent of the flange’s adhesion and therefore should any leakage make a break for freedom it will meet this second barrier which it will have to work to get past and thus gives you more time to be able to get home, or get to a toilet facility so that you can change the pouch.
The other main use for them is as an emergency leakage stop gap measure. For example, let’s say you are out on the town, or have gone shopping. You start to feel that your pouch might possibly be leaking. If you can get to a toilet then you can take your new flange extender and place it over the edge of the flange. If any creases have appeared in your flange during wear then the extender helps cover them over with fresh hydrocolloid/tape. Likewise if any leakage should be working its way under the flange and is close to breaking beyond the edge then you can stick the extender over the edge to give yourself more time to get home so that you can change your pouch in comfort. There is no reason you cannot layer the extenders two or three times themselves as well which would give you even more of a barrier to defend against the leakage.
All flange extenders I’ve seen over the last couple of years have been made of either hydrocolloid (the beige stuff our flanges are made from) or are like a sticky medical tape to look at. There are advantages and disadvantages to both, but as to which is best for you then that is very much a personal choice.
In my opinion the tape-like extenders are usually more-supple, as you’d imagine from a thin tape-like product, they can bend and crease with the body’s creases, wobbles and bulges. They are usually are a more secure adhesive too. These do not come on rolls like a medical tape, but rather they are individually cut curves. However, if you have a lot of firm or pancaking stool escaping under your flange then they tend to give way to it easier than hydrocolloid extenders.
The hydrocolloid extenders are usually thicker, and stronger, and the adhesive is often more skin friendly than the tape versions due to the hydrocolloid itself being such a skin friendly product. The hydrocolloid varieties do still stretch with the body but not always as well as tape extenders and if the hydrocolloid is too then it can be difficult for the product to fill some creases as effectively as tape.
If you have tried extenders for yourself then you’ve probably discovered that there’s a big difference between removing them from the skin and removing their overlap from your flange. When hydrocolloid sticks to hydrocolloid it might as well be welded on. So, if you are needing to remove your extender and apply a new one then tape extenders are much easier to remove from the hydrocolloid flange. If you have a hydrocolloid extender than it can just be quicker and easier to change the whole flange instead.
What follows are some reviews of four of my personal favourite flange extender products which are presented here in no order of significance. I’ll explain why I like them and their main features as explained by the company. I’ll also include contact details so you can arrange samples if you want them.
This was actually the very first flange extender product I ever tried and it’s still one of my favourites. I keep some in the pocket of pretty much every jacket or coat I own as I use them to cover over any flange creases that start lifting, or any leakage I can see coming under the flange whilst I’m out of the house. The extenders help me stop the leakage before it actually escapes and becomes a bigger problem that would require a full pouch change in a foreign environment outside the comfort zone of my own bathroom.
The OstoFIX range of flange extender is a tape-like product and as it is super thin it makes it a very supple, pliable product with all round stretch. Thanks to that there is less chance to be any edge lifting, which in turn helps the wear time of your product.
This product comes in four size varieties, the OstoFIX, OstoFIX Forty and the OstoFIX Eighty. The OstoFIX is the original straight strips which come in either a 2.5cm x 10cm length or a wider 5cm x 10cm length; the OstoFIX Forty is the largest of the four products and is a curved frame, suitable for large flanges. The OstoFIX Eighty is a smaller curved frame and is ideal for small flanges, or if you are just wanting to cover over a specific location on the edge of your flange which is usually a trouble spot for you. For example, a section of the flange which maybe always creases and leads to smells escaping from your pouch.
The OstoFIX range of flange extenders is a very secure product which can stay stuck in place for well over 48-72 hours without lifting or creasing (in my wear-time experiences). I’m sure you could get longer out of them too, but I tend to not wear any pouch beyond 72 hours at most. I would estimate that it would remain firmly adhered to the skin for at least five days with ease, and that’s the longest period for any of the four featured in this article.
The backing on the OstoFIX and OstoFIX Eighty products are split in two, giving you the advantage of being able to locate the extender without getting your greasy fingerprints on the adhesive and of course the less you can touch the adhesive the better the chance of achieving optimal adhesion from the product. The OstoFIX Forty backing is split into three sections to allow you to remove the larger middle section first and then once applied you can then easily apply the two end sections with minimal fuss.
If I do have one criticism of the OstoFIX it is that it can be uncomfortable to remove as it sticks so well and it can leave little red marks on your skin after its removal – just like Elastoplasts can do at times. Do you remove Elastoplasts slowly, or rip it off in one go? This is a relevant question with the OstoFIX too. I would suggest you use some form of medical adhesive remover to break the adhesion down a little before removal. You might even like to try the OstoMart OstoCLEAR Medical Adhesive Remover which makes the removal of the OstoFIX considerably easier or try using the OstoGUARD No Sting Barrier Film on the skin first before you apply the tape to help soothe and protect the skin from the adhesive.
Company website: http://www.ostomart.co.uk
NB: OstoMart products are available in the UK only at this time
This was one of the first hydrocolloid-based flange extenders I ever tried and from a personal stand point I’ve always found the hydrocolloid flange extenders to be better for wearing as a regular addition to your pouch application
routine, rather than an emergency stop gap measure. That doesn’t mean you can’t use hydrocolloid flange extenders for this reason, as you can, it’s down to personal choice.
The CliniMed HydroFrame moulds well to the body and offers the combined force of product strength, adhesion and skin friendliness.
The HydroFrame stays securely in place for 48-72 hours before the hydrocolloid starts to crack and breakdown. The hydrocolloid can leave some adhesive residue behind so I would suggest using a medical adhesive remover, such as CliniMed’s own Appeel adhesive remover, to get off any remaining sticky bits, or you could use it whilst removed the extender itself. Alternatively you could use a skin barrier wipes/spray such as CliniMed’s LBF range of skin barrier products.
One of my favourite features of the CliniMed HydroFrame is the ease of application thanks to the split backing on the adhesive. With the Hydroframe there are three parts to the backing. There’s a large centre piece and a smaller piece of backing left on both ends. By removing the centre backing first the HydroFrame allows you to securely place the product using both hands without it sticking to your fingers (which in turn can start to dull the adhesive on any hydrocolloid product thanks to greasy finger marks) and then you can set about securing the end pieces. It’s such a simple thing, but makes the product so much easier to apply. However, if I have one criticism about the backing it’s that the machine cuts in the backing do bite into the hydrocolloid a tiny bit and it’s usually these sections which start to breakdown first.
Company website: http://www.clinimed.co.uk or http://www.wellandmedical.com
The Coloplast Brava Elastic Tape is very much the “next generation” of flange extenders.
Whilst the company is marketing it as a “tape” it is more like a hydrocolloid extender in my eyes – although in fact, it attempts to offer the advantages of both hydrocolloid and tape-like extenders. It does this by having a bevelled profile giving the extender thin edges and a thicker core. This offers the great elasticity of a tape product, but at the same time it has the thickness and security of a hydrocolloid extender.
The product stays in place for approximately 48 hours before it starts to breakdown with the outside edge starting to roll up.
The product is very skin friendly. There is no real need to use a medical adhesive remover, and I have yet to see any reddening of the skin due to the product. The backing on it is split too, although only into two pieces rather than my personal preference of three.
Company website: http://www.coloplast.co.uk
Most people are aware that when it comes to skin care there is one product ingredient that stands head and shoulders above the rest for skin-friendliness and skin care; that is Aloe Vera.
Salts Healthcare was the first, and still one of only a small minority of ostomy product manufacturers to include Aloe Vera options to the majority of their hydrocolloid products. They are also the ONLY ostomy products company in the world which has been accredited by the British Skin Foundation for the skin friendliness of their products and their research into healthy stoma skin.
As you’ve probably guessed the Secuplast Hydro Aloe is the upgraded version of the popular Salts Secuplast Hydro flange extender. These thin strips of hydrocolloid offer a simple and effective solution to the adhesion problems flange extenders are meant to combat. With the added ingredient of Aloe Vera, as well as the accreditation of Salts Healthcare by the British Skin Foundation, then you can be sure that you are getting a product that will be as skin-friendly as it is secure and flexible.
During my wear time test it was still firmly stuck to me after 72 hours. It creased with my natural belly crease but this was no detriment to the security of the product as it had moulded well to my wonky belly and scars. Whilst it did look like it was ready for changing due to the outer layer looking wrinkly it was nevertheless firmly stuck in place so it could have lasted way beyond the period of time I wore it. Removal of the product was very easy too, no adhesive remover was required, and the skin looked the same as it was before use.
I particularly liked the size of the Secuplast Hydro as it was near perfect for my flange (Coloplast Assura). The product is one size fits all, so for most ostomates it will be more than big enough but wearers of the larger flanged products may need to use multiple strips if wanting to cover the entire side edges, or use the single extender to target the problem area.
The backing on the Secuplast Hydro Aloe Vera was not split, it all came off in one piece so you had it sticking to your fingers during application; thankfully the hydrocolloid wasn’t as tacky as some other products straight out of the box so it’s not too much of an issue.
Company Website: http://www.salts.co.uk
It’s been a few months now since I wrote this article about the current crop of flange extenders which are available to ostomates to try. Since then I’ve had an opportunity to test out the SB2 flange extender from UK ostomy company Independence Products (and manufactured by Prosys International Ltd.) and it’s very safe to say that I’ve been blown away by it. What a fantastic little product this is!
The first thing to note about it is that it adds a third category to the flange extender line up. Some companies make their extenders from hydrocolloid and others make them as a sort of curved medical tape. Independence has chosen to not go down either of these routes but instead to make theirs out of a foam-like substance.
Alison Marwood, Manager of Independence Products says: “Why would you stick another hydro-colloid frame on top of a hydro-colloid flange if the first hydro-colloid doesn’t stick… it doesn’t make sense?!” And when you think about it, that’s a very good point.
I gave the SB2’s a four day wear test. As always with my product tests I did not using any skin care products on the peristomal skin so that the SB2’s got a fair test. They were helping protect my regular flange and pouch combination of the Coloplast Assura 2pc.
During the testing time the flange extender prevented one leak from escaping my flange whilst out, and it was this that brought an end to the test as I had to do a full change of pouch and flange when I got home.
Looking at the extender at that time, it was not showing any signs of the adhesive deteriorating or lifting. I really did get the impression that it would still have been stuck on firmly after another four days or even more as it was sticking as well as the day I put it on.
The SB2’s handles showering very well. No water got underneath and neither did it penetrate into the outer most layer of the extender which is covered with a water resistant and pearlescent-looking plastic. Whilst my flange was leaking the extender itself securely held back the stool output even though my stoma was trying its utmost to embarrass me and pump out enough stool to allow it to break out to freedom. The SB2 held its ground allowing me to get home a few hours later with my dignity, and colostomy security, intact. In my opinion you cannot ask anything more of a flange extender than that.
On the skin-care side of things the SB2 left my skin slightly pink, and in continued use since then over the last few weeks it has never been anything more than that. The skin should also remain pretty good even after long term use of the extenders as they peel off very easily. It’s great to find an ostomy product which sticks when you want it to and yet is a dream to remove when you come to change your kit. Most products these days have good sticking power, but many can be a complete pain when it comes to removing them. There’s no residue left behind, except maybe a little grey adhesive fluff on the edges which just rubs off – similar to the mark plasters can leave behind when in place for any long period of time. I did not need to use medical adhesive remover to take the SB2’s off, and neither do I need to use a skin wipe before use.
The backing is all in one piece, which if you’ve read my previous four extender reviews at the top of this page then you’ll know that that is a particular bug bear of mine, but to be fair in this case the adhesive was so impressive it didn’t matter if you got sticky fingers prints all over it before application. That said though, I’d still prefer the backing in two or three pieces. But that’s just me. 🙂
This is a superb flange extender, I highly recommend it. In fact, it is now my product of choice in this department and I’ve ordered a couple of packs for my supply cupboard. Independence Products deserve huge success with this product, and if you use flange extenders in your ostomy kit then I’d be requesting a sample if I were you.
Very soft to wear | The “holy grail” of adhesives – sticks when you need it to but can be removed very easily as desired.
Single piece backing | Slight pinking of the skin (for me – might not do that for you)
Company Website: http://www.independenceproducts.co.uk
What follows is a small list of some of the other flange extender products available on the market today along with links to the company’s product page for them (when possible). Please note that this is not an exhaustive guide to all the flange extenders on the market today (Nov/Dec 2012). I’m sure I will have missed some as companies are always releasing new products and some smaller companies may not have the budget to make their products as well known as others. In this instance, products are only missing from the list because I’ve not tested them, or I’m not aware of them, and therefore it should not be taken that it’s because they are in any way an inferior product. If any companies reading this would like their flange extenders added to this please just let me know and I’ll add it asap.
Again these are presented in no particular order of relevance.
Peak Medical – VariMate Strips (as the name suggests these are straight strips, rather than curved extenders as such)
Jason D. has been a colostomate since 1997 and founded Ostomyland in 1998 after being frustrated at the lack of information he could find out about the procedure before surgery. He lives in the UK where he has a love of Westie’s and a is a huge fan of the Broadway musical Avenue Q (in which his favourite character is Trekkie Monster). You can find Ostomyland on the Google+, Facebook and Twitter social networks.
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