This topic is about finding the right fit for the flange opening when you have a new ileostomy. A person who recently had an ileostomy is concerned about whether the opening they cut in the wafer is too tight, as their stoma nurse warned that a tight fit could harm the stoma. Since the stoma doesn't have sensation, they are unsure how to determine if the fit is correct. Here are some helpful tips and advice:

1. Ideal Gap and Warning Signs
- Aim for a gap of about 1/16 to 1/8 inch (1.5 to 3 mm) around the stoma. This should protect the skin without being too tight.
- If the hole is too tight, you might not be able to fit the wafer on properly, and you could experience immediate leaks.

2. Measuring and Templates
- Measure the stoma size with each change until it stops shrinking, which can take weeks or months.
- Use the sizing guides or templates that come with the wafer boxes from brands like Convatec, Hollister, or Coloplast.
- If you don't have a guide, use the paper or plastic backing from the wafer as a quick template.
- Create a permanent template from thin cardboard or clear plastic to ensure a consistent hole size each time.
- For mature stomas, you can precut several barriers at once or order them precut.

3. Cutting Tools and Technique
- Use curved ostomy scissors or circular cutters to make cutting easier and reduce jagged edges.
- After cutting, smooth the edges with your finger to prevent them from scraping the stoma.
- Check the fit by placing the wafer (with the clear film still on) over the stoma before applying it.

4. Rings, Seals, and Convexity
- For high-output or recessed stomas, consider using a convex barrier with a protective ring like an Eakin Seal.
- Stretch or mold the ring to match the wafer hole, then apply them together.
- Keep the ring slightly away from the moist stoma to allow it to absorb moisture.

5. Practical Change Tips
- Stand up when changing the wafer; some find it easier without a mirror or by using a handheld mirror.
- Keep scissors, a pen, and your template in the wafer box, and date the box to track wear-time.
- Precut convex rings are available if you prefer not to cut them by hand.

6. Brands and Products
- Consider using Coloplast curved scissors, Hollister wafers, Convatec two-piece pouch systems, Eakin Seal protective rings, and generic circular cutters for various sizes.