Measurement of Flexibility and Compressibility in Convex Ostomy Barriers

Establishment and maintenance of a secure seal between the pouching system and the peristomal skin is a critical element of effective ostomy care. Convex skin barriers are frequently used to improve outcomes when the stoma is retracted, the os empties at or below skin level, the peristomal surface is concave or irregular, or there is high-volume or liquid output. Manufacturers have responded to the increasing use of convex ostomy skin barriers by providing a wide variety of such barriers with differing features; thus, ostomy nurses have been challenged to develop guidelines for matching convex barriers to patient needs. An international consensus conference resulted in clear definitions for 5 identified characteristics of convex barriers: depth, slope, tension location, flexibility, and compressibility. However, until recently, there have been no guidelines for objective and standard measurement of these characteristics, and for matching products to patients. A transdisciplinary consensus conference held in 2024 resulted in guidelines for measurement and labeling 3 characteristics of convex barriers: depth, slope, and tension location. That conference also generated general guidelines for the use of convexity and specific clinical implications for all 5 characteristics. Nevertheless, that conference failed to generate consensus for standardized management of flexibility and compressibility. A subsequent consensus conference was convened to focus on measurement guidelines for the 2 dynamic features of convex barriers: flexibility and compressibility. This article summarizes outcomes of the previous consensus conference and provides an in-depth report on consensus statements regarding the measurement of flexibility and compressibility.