This topic is about someone who has had an ileostomy for over 30 years and is now experiencing issues with their stoma flattening and retracting. This change has led to frequent leaks, severe skin irritation, and the need for constant appliance changes. They are considering surgical options but are looking for advice first.

Here are some helpful suggestions:

1. Consider consulting a colorectal or experienced stoma surgeon to discuss the possibility of a stoma revision. Many people with long-term ostomies have found this necessary after several decades.

2. Schedule an urgent appointment with a stoma or ostomy nurse to review your pouching technique and supplies.

3. For short-term skin protection:
- Dust irritated skin with stoma powder, then lightly dab or "crust" it with a barrier film.
- Apply a thin layer of paste or powder-paste directly around the stoma, and if needed, touching it.
- Use a pre-cut adhesive or sealing ring, then apply the pouch. Try to leave this setup in place for 2-3 days to allow the skin to heal.

4. Consider using sealing rings like Eakin Cohesive Seals, which come in different widths and thicknesses and are moldable. Other brands like Eckons/Hollister offer similar options.

5. For a flattening stoma, you might want to switch from a flat pouching system to a convex system that gently pushes the stoma outward. The Coloplast SenSura shallow convex baseplate has been mentioned as effective, though deep convex options might be too harsh for sensitive skin.

6. An additional skin-care product to consider is stoma powder, which can help protect the skin.

7. Remember, there are many convex and moldable products available. A stoma nurse can assist in trying out different brands and sizes to help stop leaks and protect your skin while you explore surgical options.