This topic is about whether barrier rings are necessary for ostomy appliances and if moldable flanges can eliminate the need for cutting. The person asking the question has always used a barrier ring but is curious if they can skip it. They also tried using a barrier ring with a moldable flange and found it didn't work well, so they are wondering if moldable flanges can seal effectively without a ring. They dislike cutting flanges and are looking for a simpler routine.

Here are some helpful insights and advice:

1. If you can find a precut wafer that fits well, it might eliminate the need for cutting. However, many people still use a ring for extra skin protection and to fill any gaps.

2. If no commercial wafer fits your stoma, cutting to fit is often the most reliable method. You can make several wafers at once, store them in their original pouches inside a zip-lock bag, and keep updated templates handy.

3. For dealing with dips or uneven skin:
- Trim a seal or ring and place only the needed piece under the depressed area to level the surface.
- Experiment with different types of rings, such as flat, convex, or Hollister's oval convex, to find the best fit and stop leaks.

4. Paste often doesn't work well in deep dips, but rings or sections of rings usually provide a better seal.

5. Some people create their own flanges or cutting jigs for precise, repeatable holes. Manufacturers like Coloplast may offer custom solutions and samples if you reach out to them.

6. Everyone's anatomy and output are different, so the best solution is personal. Some successful combinations reported by others include:
- A one-piece convex wafer with a barrier ring (cut-to-fit)
- A moldable or precut convex wafer with a full-ring seal
- A self-made or heavily modified flange with a standard ostomy pouch

These insights might help you find a routine that works best for you.