There are several externally worn appliances that can be used to protect the skin from the constant leakage of liquid stool or urine, which can occur in association with medical conditions and disorders in which bowel and/or bladder control is lost. These appliances are usually referred to as external incontinence devices.

Although there are several different products available, the general features of these products are described below:

FECAL INCONTINENCE DEVICES:
Several external collection devices are available for management of chronic diarrhea and/or fecal incontinence. These devices consist of a drainable pouch that is attached to an adhesive wafer. This wafer has a hole cut through the center that fits over the anal opening (rectum).

With proper application, a fecal incontinence device may remain in place for 24 hours. It is important to remove the pouch if any stool leakage has occurred. Liquid stool is very caustic to the skin and may lead to skin irritation and breakdown.

If leakage has occurred, always cleanse the skin and apply a new pouch.

Applying a Fecal Incontinence Device:

The fecal collection device should be applied to clean, dry skin:

• Often a protective skin barrier prescribed by your healthcare provider is applied to the skin prior to attaching the device. You can also use a skin barrier paste to fill in the skin folds of the buttocks to prevent leakage of liquid stool through this area.
• Spread the buttocks apart, exposing the anus. It may be helpful to have one person support the buttocks while another applies the wafer and pouch. The wafer should conform to the skin with no gaps or creases where liquid stool can seep through.
• It may be necessary to trim the hair around the anus to help the wafer adhere better to the skin.

Several different types of external fecal collection devices are available. An enterostomal therapy nurse or skin care nurse can provide you with a list of products that are available in your area. (See also skin care and incontinence.)

URINARY INCONTINENCE DEVICES:
A variety of external collection devices are available for men and women.

Condom Catheter:

The systems for men usually consist of a pouch or condom like device that is securely placed around the penis.

This is often called a condom catheter. A drainage tube is attached at the tip of the device to remove urine. The drainage tube then empties into a storage bag, which can be emptied directly into the toilet.

Condom catheters are most effective when applied to a clean, dry penis. It is sometimes helpful to trim excess pubic hair from the area, because excess hair may prevent the appliance from securely attaching to the penis.

These devices must be changed at least every other day, to protect the skin of the penis and prevent urinary tract infections. Make sure the condom device fits snugly but not too tightly, as this may cause skin breakdown.

Devices for Women:

External collection devices are available for women, although these devices are less successful in containing urine.

The devices are similar to the fecal incontinence pouches described above and they consist of a pouch with a sticky wafer that is attached to the vulva. The end of this pouch is connected to a larger drainage bag.