Which pouching configuration is specified as a consideration for peristomal hernias?

• A. Flexible system
• B. No rigid or convex systems
• C. Floating flange or flangeless systems
• D. All of the above

Answer: (D)

When a peristomal hernia is present, the goal is to choose a pouching setup that can adapt to irregular contours around the stoma and avoid placing pressure on the hernia site. Flexible systems mold to the belly wall and stoma, creating a seal without rigid edges that could irritate or compress the herniated area. Rigid or convex designs can push against the hernia or create focal pressure, increasing discomfort and risking leakage. Floating flange or flangeless options offer a way to accommodate uneven peristomal tissue and reduce flange-induced pressure, making it easier to achieve a comfortable, secure fit as the hernia varies with movement or gas. Because each of these approaches addresses fitting around a hernia and protecting the skin seal, considering all of them is appropriate.