Apparatus for stoma bag

Abstract

A device 100 for emptying a stoma bag having a drainage opening, the device comprising a clip 1 which includes a pair of arms 2, 3, the arms being hingedly 5 attached to each other at a first end of the arms. There is a gap 4 between the arms for accommodating a stoma bag. The device may further comprise a case 10 which, in use, is located at least partially over the clip to maintain the gap between the arms to an essentially constant width, the case preventing the arms from being forced apart when the clip is used to empty a stoma bag. The device may further include first and second holding means 11a, 11b at each end of the device – such as on the case - the holding means being for holding a waste receptacle, such as a waste disposal bag, in position so that as the device is slid along the length of the stoma bag, the contents of the bag are expelled from the drainage opening into the waste receptacle attached thereto. A method of using the device to drain a stoma bag is also disclosed.

Description

Technical Field The present invention relates to a device to aid the emptying of a drainable stoma bag. Background to the Invention A stoma (also called an “ostomy”), is a surgically created opening on the surface of the abdomen through which body waste is diverted. Many medical conditions can lead to the requirement for a stoma, including bowel cancer, diverticulitis, Crohn’s disease, Multiple Sclerosis and a trauma to the abdomen. It is currently estimated that over 100,000 people in the UK have a stoma and that over 10,000 stoma operations are carried out in the UK each year. The term “ostomates” is used herein to refer to people who have a stoma. Stomas can be created by a colostomy, an ileostomy or a urostomy. In a colostomy, the stoma is created using the colon or lower bowel, whilst in an ileostomy the opening is created using the small intestine or ileum. In both cases, faeces are diverted through the stoma and are collected in a stoma bag (also known as an ostomy bag), which is attached over the opening. In a urostomy, the opening is connected to the ureters thereby by-passing the bladder so that urine is diverted through the opening. Again, a stoma (or ostomy) bag is attached to the abdomen to collect the urine. The term “waste material” is used herein to refer to any matter being passed out from a stoma, whether urine, liquefied faeces or more solid faecal matter. A stoma bag typically comprises a flexible bag for the collection of the waste material, which includes a water-proof or impermeable lining, together with a stoma bag flange, typically of a flexible plastic, which bears a skin-friendly adhesive. There are a number of different bags and designs for different applications and needs, with one design being a drainable stoma bags which comprises a drainage opening. The waste material collected in drainable stoma bags is typically removed by means of a closeable drainage opening positioned at the bottom end of the bag. Emptying the bag can be accomplished whilst the bag is in use (still attached to the patient) allowing for more continued use of the stoma bag. The waste material from the stoma bag can emptied into a suitable receptacle, such as a toilet, which can then simply be flushed. However, draining the bag is often a difficult task for many ostomates. For example, the current UK NHS advice to empty a drainable stoma bag is to kneel at the side of a toilet to carry out the drainage procedure. However, kneeling is not always possible due to mobility issues, and also, in a public toilet, this is not always a hygienic option. It can also be difficult to both direct the waste out of the drain of the stoma bag whilst simultaneously pushing the waste out of the bag. Often two hands are required to push the waste out of the stoma bag, meaning that the ostomate does not have a free hand to accurately direct the stream of waste being expelled. Thus, it can be hard to direct the stream of waste accurately into a toilet, and error can result in waste being accidently sprayed around the area, which is both unhygienic and embarrassing. US4642106 describes a device having two arms which come together and extend partially across a stoma bag. The device can be slid along the length of the stoma bag to assist pushing out the contents. However. Since the device only spans part of the width of the device, some contents are likely to remain. US9101482 also describes a device having two arms which come together and can be slid along the length of the stoma bag to push out the contents. The arms extend across the width of the stoma bag and fasten by means of a gripping element. The bag is designed to be used in conjunction with a suitable receptacle, such as a toilet, to receive the expelled contents of the stoma bag. Since the arms are fastened at each end it is possible for the device to flex in the middle. Both of these prior art devices also still require careful aiming of the stream of expelled waste material into the selected receptacle. There remains a need for a device which can assist ostomates in emptying drainable storage bags. There is also a requirement for ostomates to have an option for emptying the bag when no toilet is easily available. Brief Description of the Invention The present invention provides a device for emptying a stoma bag (also called an ostomy bag) having a drainage opening. The device comprises a clip which includes a pair of arms each arm having first and second ends, wherein each arm is able to span the widest point of a drainable stoma bag, and wherein said arms are hingedly attached to each other at the first end of the arms. In one embodiment, the device further includes a first holding means at one end of the device and a second holding means at a second end of the device. In use, the holdings means can retain a waste receptacle, such as a waste disposal bag, in position so that as the device is slid along the length of the stoma bag, the contents of the bag are expelled from the drainage opening in a controlled manner into the waste receptacle attached thereto. In an alternative (or additional) embodiment, the device comprises a case which is slid over the clip. In use, the case causes the arms of the clip to be maintained in a rigid configuration, whilst the stoma bag is emptied, i.e., prevents the arms from being forced apart. The case can be used as a closure means for the hinged arms, so that the ostomy bag is held between the arms. Optionally, the case can also help the user to grip the device. Brief Description of the Figures Fig. 1: Shows a perspective view of one embodiment of the clip of the invention. Fig. 2: Shows the top view of the embodiment of the clip shown in Fig. 1. Fig. 3: Shows the embodiment of the clip shown in Figs. 1 and 2, with the hinged arms open. Fig. 4: Shows a schematic cross-section of the clip, positioned around a stoma bag. Fig. 5: Shows a perspective view of the case, suitable for holding the clip of Fig 1. Fig. 6: Shows an alternative perspective view of the case of Fig. 5. Fig. 7: Shows a perspective view of the assembled device of the invention with the clip inserted into the case. Fig. 8: Shows the assembled device with the clip inserted into the case, from another angle. Fig. 9: Shows the device with the clip partially inserted into the case. Fig. 10: Shows the device with the clip partially inserted into the case, from another angle. Detailed Description of the Invention The device of present invention is now disclosed in further detail. In a first aspect, the present invention provides a device comprising a clip formed from first and second arms each having first and second ends, and connected together by a hinge at the first end, said device further comprising a first holding means at a first end of the device and a second holding means at a second end of the device. The first and second holding means are for securely holding a waste bag in position to receive waste from the stoma bag. In a second aspect, the present invention provides a device for emptying a stoma bag, said device comprising a clip formed from first and second arms each having first and second ends, and connected together by a hinge at the first end, wherein said clip has a gap between said arms to accommodate the thickness of a stoma bag, said device further comprising a case which, in use (i.e. during emptying of the stoma bag), is located at least partially over the clip and maintains the gap to an essentially constant width. The following description applies to both the first and second aspects of the present invention. The gap between the two arms is sized so that the clip can be positioned onto a drainable stoma bag, with one arm located either side of the bag. The length of the arms allows the clip to span the widest point of a drainable stoma bag. In use, the device can be positioned onto the stoma bag below its flange, and the device can then be slid along the stoma bag to urge waste therein along the bag and out of the bag’s drainage opening. The arms of the clip can be formed so that the gap between them is sufficient to accommodate the thickness of the stoma bag. The gap between the arms is dependent on the thickness of the user’s stoma bag. Typically, a gap size of 0.04 mm to 0.4 mm is considered sufficient, for example a gap size of 0.1 mm. A gap size which is too large relative to the thickness of the stoma bag could result in waste in the bag not being pushed down by the device, and lead to inadequate emptying of the bag. A sufficient degree of friction can also help the device stay in place on the stoma bag for storage in between emptying; this is particularly useful for less mobile users who would otherwise need to find and locate the device each time the bag requires to be emptied. Optionally, with the clip is attached to the stoma bag, the material of the stoma bag is positioned between the arms of the clip. In one embodiment, the arms have a profile which takes the bag away from the body of the user, for example the bag can describe a diagonal path through the clip. Alternatively, the arms can be formed so that the material of the stoma bag is urged into a curved or tortuous path as it passes through the clip, which results in more friction between the clip and the stoma bag when in use. When the device is slid down the stoma bag, the greater friction ensures that waste in the bag is also pushed down by the clip, and ultimately drains from the bag. Conveniently, the hinge can be formed from the same plastics material as the arms of the clip. Non-limiting examples of suitable materials include polyethylene (e.g., high density polyethylene, and including recycled polyethylene), nylon (e.g., nylon 12), polypropylene, polyethylene terephthalate (PET), polylactic acid (PLA) and the like. Polypropylene is a preferred material. The hinge can conveniently be formed from cast, moulded, or printed plastics. Alternatively, the arms of the clip can be formed from a suitable metal, such as steel. The arms of the clip may be formed from the same or different material as the hinge. Optionally the arms of the clip may be formed from a plastics material having a metal reinforcement. Optionally, the arms of clip can terminate with a pointed region, located distal to the hinge. The pointed region can help locate the clip into the case when the clip is fastened to a stoma bag. The narrowed end also facilitates cleaning around the stoma bag flange, specifically can be used to help move waste in the area above or next to the stoma bag flange. Since the stoma bag flange is adhesively attached to the patient’s skin, it is not possible for the device to be located either side of the stoma bag at these locations, and the deice is typically attached to the stoma bag below the flange and will push waste matter downwardly from the position to the stoma bag outlet. Should any matter be located next to or above the flange, the device can be removed and the pointed end of the clip used to move such matter to a position below the flange. The device can then be re-attached and used to expel this matter from the stoma bag. The hinge is located at one end of the clip. Optionally, the hinge allows the arms of the clip to be opened so that the clip can be positioned around the stoma bag, with one arm located either side. Optionally the hinge has sufficient rigidity that it holds the arms in an orientation which maintains the gap between the two arms of the clip. Optionally, the hinge has sufficient rigidity that the first and second arms of the clip are maintained substantially parallel to each other. Conveniently, then hinge can be formed from the same plastics material as the arms of the clip. Nonlimiting examples of suitable materials include polyethylene (e.g., high density polyethylene, and including recycled polyethylene), nylon (e.g., nylon 12), polypropylene, polyethylene terephthalate (PET), polylactic acid (PLA) and the like. Polypropylene is a preferred material. The hinge can conveniently be formed from cast, moulded, or printed plastics. Advantageously, the entire clip, the hinge and the arms, can be formed in a single piece, for example from one cast, mould or print. Alternatively, the arms and the hinge can be formed from different materials. Alternatively, the hinge can be formed from a suitable metal, such as steel. Optionally the arms of the clip may be formed from a plastics material having a metal reinforcement. In one embodiment, the clip has a generally rectangular cross-section when the two arms are located together, and the gap between the arms (to accommodate the stoma bag) runs diagonally. This, the cross-section of each arm is essentially triangular. In the first aspect of the invention, the device can optionally further include a case which, in use, is positioned at least partially over the clip. The case forms an essential part of the assembled device in the second aspect of the invention. The clip can be inserted into the case whilst the device is not in use and / or during use when the clip is fastened to a stoma bag. The case can help to protect the clip when not in use. The case is sized and shaped to maintain the arms of the clip in the required alignment, with a gap of constant width between the two arms. Advantageously, since the clip maintains the arms of the clip in the required alignment, an even pressure is applied across whole width of the stoma bag to move the contents down and out of the bag. Case holds the arms of the clip securely either side of the stoma bag and maintains the essentially the same pressure between the arms along the whole width of the clip. As the device is slid down the stoma bag any contents are caused to move towards (and out of) the stoma bag outlet. Since the gap between the arms has the same size across the whole width of the bag (due to the interaction of the clip and case), an even pressure is created across the whole width of the stoma bag which leads to the bag being completely emptied. In other word, the device of the invention has the advantage that the contents of the stoma bag cannot be squeezed to one side or upwardly during emptying. In one embodiment, the case comprises an end region (into which the tapered, pointed end of the clip is inserted) which forms two arms, which locate around the clip. Optionally, each arm can have an essentially “L-shaped” cross-section, so that the arms “wrap around” the clip to hold it securely in place. The “L-shaped” cross-sectional shape of the arms also provides gaps at the top and bottom surfaces of the case which allow entry and exit of the stoma bag, thereby allowing the whole device to be slid down the stoma bag in order to empty it. The space between the two arms of the case allow the stoma bag to enter and exit the device. Optionally, the case can have an ergonomic grip on its external surface, which can aid the user during to move the device in order to empty the stoma bag. In use, when the device is pushed down the stoma bag, pushing waste down and out of the stoma bag, the ergonomic grip gives the user greater control of the device and makes the device easier to use. This is particularly important for users with limited or compromised ability to grip. Optionally, the case can comprise holding means for a waste bag. A suitable waste bag can be a plastics waste bag. A suitable waste bag can be a plastics waste bag with handles which can be tied together once the bag has been filled. The holding means can be in the form of hooks or notches or any other suitable attachment options for securing a waste bag. For example, the case can include two notches which can be used to securely locate handles or arms of a plastic waste bag. The holding means allows the waste bag to be attached to both ends of the device. In other words, the waste bag can be suspended between the holding means at either end of the device. This ensures that the waste bag is held in a suitable position to be filled from the stoma bag. The stoma bag drainage opening can then be placed into the waste bag and the stoma bag emptied into the waste bag by sliding the device along the stoma bag. The holding means ensures that waste bag remains securely in place whilst the stoma bag is emptied, minimising any spillage and keeping the process hygienic. Advantageously, the stoma bag can be easily drained without immediate access to a toilet. Optionally, the case can have an attachment means for the clip. The attachment means can be in the form of grooves or notches or any other suitable holding system which can maintain the clip and case together. The attachment means secures the case onto the clip so that the clip and case are secured together in a removable fashion. Ensuring that the case is secured to the slip is particularly important when the device is use, as the user is required to exert force on the device, increasing the potential that the case may slip off the clip. Optionally, the attachment means may be on the clip. Optionally co-operating portions of the attachment means may located on both the clip and the case. For example, the attachment means can comprise male and female members which can be snapped together in a secure manner. Alternatively, the attachment means can comprise elements which form a close fit together when the case is attached to the clip, so that the case is maintained in position by friction. Conveniently the case can be formed from plastics materials, for example from mouldable or extrudable plastics. Nonlimiting examples of suitable materials include polyethylene (e.g., high density polyethylene, and including recycled polyethylene), nylon (e.g., nylon 12), polypropylene, polyethylene terephthalate (PET), polylactic acid (PLA) and the like. Polypropylene is a preferred material. The hinge can conveniently be formed from cast, moulded, or printed plastics. To facilitate the drainage of a drainable stoma bag, the clip is first positioned over the bag, with one arm of the device either side of the bag and with the clip is situated above the waste within the bag, but below the flange of the bag. The case can then the slid over the clip, such that the arms of the clip are maintained is a “locked” position. The friction between the arms of the device and the stoma bag maintains the device in position until the user is ready to empty the stoma bag. The case can also allow the user a better grip of the device, facilitating emptying. Once the stoma bag is to be emptied, a waste bag (such as a plastic bag or similar) can be located onto the holding means and positioned so that the drainage opening of the stoma bag is within the waste bag. The device can then be slid at least part way down the stoma bag pushing any waste in the bag down to the bottom portion of the stoma bag. The drain can then be opened and the waste pushed out of the stoma bag. Alternatively, once the stoma bag is to be emptied, a waste bag (such as a plastic bag or similar) can be located onto the holding means as before and positioned so that the drainage opening of the stoma bag is within the waste bag. However, the drainage opening can be opened first and then the device can be slid down the stoma bag, pushing the waste down the stoma bag and out of the drainage opening. The device does not need to move past the drainage opening of the stoma bag. As the device moves down the bag, the waste bag moves downwardly also. The device can be pushed down the stoma bag with one hand. Alternatively, the device can be slid all the way off the stoma bag, and the device then form a handle to the waste bag, which will now be suspended from the device and will also be holding the waste material expelled from the stoma bag. The waste bag can be taken off the device and sealed for disposal. Use of the device of the invention does not require the user to kneel by a toilet in order to drain their stoma bag. This is particularly useful to ostomates with mobility issues and is also a more hygienic option, particularly in public settings. Additionally, since the user can attach a waste bag to the attachment system on the device and empty the waste in the stoma bag into the waste bag, the user to empty their stoma bag without requiring access to a toilet. Afterwards, the waste bag can be sealed and then disposed of hygienically. Thus, the present invention further provides a method of draining a stoma bag comprising providing a device according to the invention as described above, said method comprising positioning the clip onto a stoma bag having a drainable opening, such that the clip is above waste in the stoma bag, and moving the clip along the stoma bag towards the drainable opening. Optionally, the method comprises the step of locating a waste bag onto holding means on the device prior to emptying the stoma bag. The stoma bag outlet should be positioned in the waste bag prior to the emptying step. Figure 1 shows a perspective view of the clip 1 according to the invention when not in use. The case 10 is not shown for clarity. Clip 1 is formed from two arms 2, 3 separated by gap 4 of substantially constant width which is sized to accommodate the thickness of a drainable stoma bag. Hinge 5 maintains the gap 4 between arms 2, 3 when clip 1 is in use. The arms 2, 3 terminate with a pointed and tapered region 7, located distal to hinge 5. As illustrated, hinge 5 is formed integrally with the arms 2, 3 of the clip 1, although other arrangements are also possible. Fig. 2 shows the top view of the clip illustrated in Fig. 1. As shown in Fig. 2, gap 4 is visible in the top surface 8 of the clip 1. The gap is maintained between arms 2, 3 from top surface 8 to the bottom surface of clip 1. The position of gap between arms 2 and 3 can maintained in a constant position as shown to the bottom surface of the clip. In this embodiment, the width of arms 2 and 3 on the bottom surface would be as shown in Fig. 2 for top surface 8. Alternatively, when viewed in crosssection, gap 4 can run diagonally through the body of the clip, and the widths of arms 2, 3 will vary through the height of the clip. Thus, each arm 2, 3 will be essentially triangular in cross-section. As illustrated, clip 1 also features an attachment means 6 for securing clip 1 within a case (not shown in Figs. 1 and 2). Figs. 1 and 2 show attachment means 6 as a male protrusion which can be located into a corresponding female notch or groove of attachment means 12 in case 10, see Fig. 3. The converse arrangement is of course also possible. Typically, there can be an attachment means 6 on each side of the clip. Figure 3 shows the clip of Figs. 1 and 2 when open. Hinge 5 has been flexed to allow arms 2, 3 to move apart. As illustrated, face 9 of arm 2 is a sloping face which, when the clip is in the closed configuration, locates opposite an equivalent sloping face in arm 3 to form a gap of essentially constant width which accommodates the thickness of a stoma bag. Figure 4 is a schematic cross-section of the clip 1 in its closed configuration, and shows the opposite sloping faces 9a, 9b of arms 2, 3 respectively and gap 4 formed therebetween. Fig. 4 shows the essentially triangular cross-section of each arm 2, 3. A stoma bag 20 is shown in cross-section located within gap 4. As can be seen in Fig. 4, gap 4 is sized so that the clip (and thus the whole device of the invention) can be slid easily along the stoma bag 20, thereby urging any waste matter below the device of the invention downwardly to the stoma bag outlet. Figures 5 and 6 each show a perspective view of case 10 according to the invention, also when not in use. The clip 1 is not shown for clarity. Case 10 is formed from 2 essentially parallel arms 13, 14 connected by end 15. Case 10 is sized and shaped so that clip 1 can be securely located between arms 13, 14. The internal shape described by arms 13, 14 will accommodate the tapering pointed shape of clip 1. In particular, it can be seen that the thickness 16 of arm 13 is increased towards end 15 and that this accommodates the tapering shape of the clip 1. A similar change in thickness of arm 14 can also be present. As shown each of arms 13, 14 have an essentially “L-shaped” cross-section, so that the arms “wrap around” the clip to hold it securely in place. The “L-shaped” cross-sectional shape of arms 13, 14 also ensures that there are gaps at the top and bottom surfaces of the case which allow entry and exit of the stoma bag, thereby allowing the whole device to be slid down the stoma bag in order to empty it. Top gap 17 can be seen in Figs. 5 and 6, and bottom gap 18 can be seen in Fig. 5. As illustrated, case 10 also includes holding means 11 as means of securing a waste bag to the case 10. Figure 3 shows holding means 11 as a series of notches 11a, 11b which can secure the handles of a waste bag (not shown). Optionally, holding means 11 can be in another form, for example can be a hook or other means which can securely attach a waste bag to case 10. Holding means 11 as shown is formed from two pairs of notches, 11a and 11b. The pair of notches 11 a is situated close to one end of case 10 and the pair of notches 11 b is situated close to the other end of case 10. Optionally, each arm 13,14 includes one member from each pair of notches. As illustrated, case 10 includes notches 11 on both the upper and lower surfaces of each arm so that the orientation of the case is immaterial to the user. In use, however, only the notches on the upper surface are required. In use, a handle of the waste bag is placed onto each pair of notches 11a, 11b, so that the waste bag is held open by holding means 11 and is ready to be filled with the waste material from the stoma bag. This makes draining the stoma bag into the attached waste bag an easier process. Placement of holding means 11 a, 11 b close to the ends of case 10 also ensures that the waste bag is balanced when suspended below case 10. As shown, case 10 also features an attachment means 12 for holding clip 1 securely within the case 10. Figures 5 and 6 show attachment means 12 as female notch or groove which corresponds to the male protrusion of holding system 6 on clip 1 (shown in Figs. 1 and 2). As clip 1 is located into case 10, the male protrusion 6 becomes located into the notch of groove 12, so that the clip and case are secured together. Optionally, attachment means 12 can be in another form provided it can securely hold clip 1 within case 10 in a removable manner. Optionally, there can be more than one set of co-operating attachment means on both the clip and the case. Figures 7 and 8 show a perspective view of the assembled device 100 of the invention formed when clip 1 is located in case 10. The stoma bag is not shown for clarity. As shown the tapered, pointed end 7 of the clip is positioned within the case 10 at end 15 of the case. Hinge 5 of the clip 1 is shown protruding slightly from case 10 and provides a means of disengaging the clip 1 from the case 10. The stoma bag is not shown, but in use would be located in gap 4. Male protrusion 6 has been located into the notch of groove 12, so that the clip 1 and case 10 are secured together. In use, the clip would be located onto a stoma bag below the stoma bag flange but above the drainage outlet, so that one arm 2 is positioned one side of the bag and the other arm 3 is position on the opposite side of the stoma bag. The length of arms 2, 3 is sufficient so that the whole width of the bag is accommodated. Once the clip 1 is in position with one arm either side of the stoma bag, the case 10 is slid over the clip 1 until male protrusion 6 has been located into the notch of groove 12. Case 10 holds the arms 2, 3 of clip 1 securely either side of the stoma bag and maintains the essentially the same pressure between the arms along the whole width of the clip 1. The device 100 can then the slid down the stoma bag so that any contents are caused to move towards (and out of) the stoma bag outlet. Since the same width of the gap 4 is maintained across the whole width of the bag (due to the interaction of the clip 1 and case 10), the stoma bag can be completely emptied. Optionally, a waste bag can be secured onto the pairs of notches 11a, 11b and the stoma bag outlet positioned so that the contents of the stoma bag are received directly into the waste bay, which is held in position by the notches 11a, 11b. Use of a waste bag avoids the need for access to a toilet and / or for the ostomate to have to kneel next to toilet in order to empty the stoma bag. Figure 9 shows a perspective view of device 100 in which clip 1 is in the process of 5 being located into case 10. Figure 10 shows the same embodiment of clip 1 partially situated in case 10 to that of Fig. 9, although from a different perspective. 10 All documents referred to herein are incorporated by reference. Any modifications and / or variations to described embodiments that would be apparent to one of skill in art are hereby encompassed. Whilst the invention has been described herein with reference to certain specific embodiments and examples, it should be understood that the invention is not intended to be unduly limited to these specific 15 embodiments or examples.

Claims

1. A device for emptying a stoma bag, said device comprising a clip formed from first and second arms each having first and second ends, and connected5 together by a hinge at the first end, said device further comprising a first holding means at a first end of the device and a second holding means at a second end of the device, wherein said first and second holding means are for securely holding a waste bag in position to receive waste from the stoma bag.10 2. The device as claimed in claim 1, which further comprises a case which is positioned at least partially over the clip.

3. The device as claimed in claim 2 wherein the first and second holding means are located on the case.

154. The device as claimed in claim 3 wherein the first and second holding means are notches formed in the case.

5. The device as claimed in any one of claims 2 to 4 wherein the clip and case are 20 secured together in a removeable manner.

6. The device as claimed in any one of claims 1 to 5 wherein the clip is formed in one piece.25 7. The device as claimed in any one of claims 1 to 6 wherein the case has an ergonomic grip.

8. A method of draining a stoma bag comprising providing a device as claimed in any one of claims 1 to 7, said method comprising positioning the clip onto a30 stoma bag having a drainable opening, such that the clip is above the waste in the stoma bag, moving the clip along the stoma bag towards the drainable opening.

9. The method of claim 8, wherein said method comprises the step of locating a waste bag onto the holding means prior to emptying the stoma bag.13 03 25

Images