This topic is about managing leaks that occur when a stoma has an off-center opening. This can cause stool to flow under the flange or wafer, leading to leaks. Here are some tips and insights to help manage this issue:

1. **Barrier Paste**: Using barrier paste can help reduce leaks. It’s important to apply it carefully, as skipping it during a hurried change can lead to major leaks. Keep experimenting with the paste to see if it works for you.

2. **Moldable Barrier Rings**: These can be very effective. Push the ring through the wafer hole and roll it up around the stoma to create a "turtleneck" seal. This method is known to stop seepage under the flange.

3. **Convex Systems with Rings**:
- If your stoma protrudes, using a convex wafer can help. Leave a slight gap in the ring on the side where the opening is, to prevent effluent from forcing itself underneath.
- Some users have found that using products like the Coloplast SenSura Mio Convex Flip can extend wear time from 2 days to 3-4 days.

4. **Barrier Paste Application**: Apply a liquid or tube paste to create a small "ramp" from the low side of the stoma up to the ring. This helps divert output away from the flange.

5. **Stoma Collars/Lip Devices**: Consider requesting samples of stoma collars, such as the Salts Healthcare Dermacol, which are size-specific. These devices can help channel output over the barrier.

6. **Additional Adhesives**: Using extra adhesive can improve the seal. Although some products like the 7730 adhesive are no longer available, alternatives like "Probond" medical prosthetic adhesive might be useful.

7. **DIY Baseplates**: Creating a custom baseplate with a detachable 90-degree bend can help direct output straight into the pouch, reducing the risk of leaks.

8. **Trial and Error**: Be prepared for some trial and error, as results can vary depending on the shape and protrusion of your stoma.

9. **Surgical Option**: If conservative measures do not work, especially with a flush stoma, surgery to reposition the stoma might be an option. Some have found that surgery eliminated leaks and blockages.