This topic is about finding practical solutions for sizing issues with the wafer opening of a pouching system for someone who has recently had an end ileostomy. The person is struggling to determine the correct size to cut the wafer opening, as advised by stoma nurses, and is seeking advice from others who have faced similar challenges.

Here are some helpful insights and suggestions:

1. Providing more details about the specific issues, such as whether the problem is leaking, skin irritation, or if the opening is too tight or too loose, can help in identifying the right solution.

2. Consider using a moldable wafer, like the Convatec Natura Moldable Technology flange, which can stretch to fit the exact shape of the stoma, eliminating the need for cutting.

3. An Eakin Cohesive Seal, or Eakin ring, can be used under the wafer. It helps fill any excess space if the hole is cut slightly too large and creates a better seal, often staying in place for about a week.

4. Be aware that the stoma may change size and shape for several months after surgery. Once it stabilizes, measure it accurately and have your supplier provide pre-cut wafers for a precise and clean edge. For example, one person's stoma settled at a size of 30 mm × 28 mm oval.

5. If you experience persistent leaks, especially at night, it might be necessary to try a different appliance style. A convex pouching system resolved this issue for one user.

6. Continue working closely with your stoma care team. They have access to the latest products and can help adjust your equipment until you find the right fit and seal.