All Pouchkins skin barriers are provided without a starter hole. Many children may have more than one stoma (such as a double barrel stoma) or skin barrier placement may be difficult given the smaller dimensions of an infant’s abdomen. The absence of a starter hole allows for the best placement on the abdomen, as placement is not dictated by a pre-determined center. Should the stoma be adjacent to bony prominences, or wounds or drains, space may be limited. A skin barrier that can be moved to a different position because it has no starter hole can make pouching output from a stoma or fistula easier.