Ostomy pouch systems vary depending on a patient’s specific conditions and needs. Four popular ostomy pouch systems include closed pouches, drainable pouches, two-piece systems, and one-piece systems. When your colostomy operation is complete, your stoma care nurse will be able to help you decide what kind of ostomy system will work best for you as you heal. As you progress in your at-home stoma care, your needs may change to where a different type of ostomy system will be better suited for you. This article discusses four popular ostomy system types.

Four Types of Ostomy Systems:

  • Closed pouch ostomy systems
  • Drainable pouch ostomy systems
  • Two-piece ostomy systems
  • One piece ostomy systems

Closed Pouch Ostomy Systems

Ostomy systems that are closed pouch allow for comfort in movement and assurance of leak protection during movement. These are switched out with a new pouch one to three times daily. There are two different closed pouch manufacturers that actually make flushable pouches that can be flushed down the toilet as a whole, rather than emptying the contents into the toilet and discarding the pouch in the trash. Cons of a closed ostomy pouch systems include: potential necessity of changing pouches when away from the comfort of one’s home, needing to empty out non-flushable pouches (which is difficult for some patients,) and these systems’ lesser ability to manage a more liquid output.


  • Comfort and assurance during movement
  • Replaced a few times daily
  • Some flushable pouch options available

Drainable Pouch Ostomy Systems

Drainable pouches are better suited to handle liquid output than are the closed pouch systems. These systems also do not need to be changed quite as frequently, meaning that fewer pouches get used overall. They are also easy to empty before disposal. Difficulties of using a drainable pouch ostomy system are: thicker-consistency outputs are difficult to drain out, there must be very delicate and detailed care taken when cleaning the stoma, and at times, the system’s clip or fastener has been reported to be uncomfortable.


  • Securely handles liquid output
  • Requires fewer pouches overall and fewer changes
  • Easy emptying

Two-Piece Ostomy Systems

With the two-piece ostomy systems, an important advantage is their ability to remain in place for two to four days. Without constant removal and replacement of the flange multiple times per day, two-piece systems therefore are more gentle to your skin. The two-piece systems’ with stick-on ability are easier to apply and remove for patients who have arthritis. The systems with clip-on ability are more user-friendly to visually-impaired patients. Downsides of two-piece ostomy systems include: some patients find keeping the flange clean to be difficult; leakage that can occur behind the flange may go undetected and irritate the wearer’s skin; and a few systems are known to be bulky or rigid.


  • Changed far less often than other systems
  • Gentler to skin
  • Options for easy application for patients with arthritis and/or visual impairment

One-Piece Ostomy Systems

A one-piece ostomy system is automatically less bulky and more flexible than a two-piece system. This allows the system to adhere more securely to uneven skin that may be damaged by scarring. Some cons of one-piece systems are that the pouch absolutely must be correctly positioned around the stoma every single time it gets changes in order for it to work properly; also, the frequent changes required for this type of ostomy system may irritate the skin.


  • Not bulky
  • Has some flexibility
  • Securely adheres even to scarred skin


The type of ostomy pouch you prefer to use on a regular basis will depend on your lifestyle, other medical conditions you may have, your diet, and other factors. It is a good idea to consult with your stoma care nurse.