Evolution of Ostomy Pouch Design: Opportunities for Composite Technologies to Advance Patient Care

Stoma surgery can be critical in helping to restore the well-being of patients suffering from gastrointestinal disease or injury but it inevitably comes with numerous psychological and physiological complications. Disposable pouch systems which enable the collection of bowel waste have revolutionized stoma care but providing robust, discreet devices that can efficiently meet the requirements of the patient can be challenging. Pouches must securely store a microbially active waste whilst preventing leakage, protecting the underlying skin from inflammation and minimizing odor. All of this needs to be achieved within the design constraints of a pouch that is easy to manage and yet still maintains a discreet body contour. Stoma collection has moved from the waste being collected in butyl rubber pouches to much more elaborate systems incorporating assemblies of polyvinylidene chloride, ethylene vinyl acetate, ethyl vinyl alcohol and polyvinyl alcohol with new, skin-friendly adhesive such as hydrocolloid and silicones impregnated with ceramides and aloe. Moreover, 3D printing has emerged as a means of providing personalized stoma pouches that can potentially address the age-old issue of leakage. Despite such advances, stoma pouches have evolved slowly over the past 70 or so years. A survey of the literature reveals an abundance of quality-of-life studies but a dearth of reports addressing the key technological challenges. Consequently, this narrative review considers current stoma pouch technology and highlights the issues that continue to afflict stoma patients. Research and patent literature is critically appraised in terms of current pouch technology and the potential opportunities for new composite materials are identified.