This topic is about managing chronic leaks and severe skin irritation around an ileostomy, which can be a challenging situation. The poster's husband has been dealing with these issues after having his colon removed due to Crohn’s disease. Despite following medical advice, they are still struggling with frequent leaks and skin irritation. Here are some helpful suggestions and insights that might make things a bit easier:

1. Seek expert review:
- Ensure the current nurse is a certified enterostomal (ET/WOC) nurse. If not, consider getting a referral to one or consult another colorectal surgeon to see if the stoma placement or construction is causing the leaks.

2. Explore additional resources and product samples:
- Check out “Ostomy Tips” in the site’s Collections for detailed discussions on leaks.
- Reach out to manufacturers for free samples, as different products may work better on uneven skin.

3. Improve flange adhesion:
- Warm the flange or baseplate with a hair-dryer before applying to make it stick better.
- Press the pouching system firmly against the abdomen for at least 60 seconds after applying.
- Make sure the skin is completely dry before attaching the appliance.

4. Fill in skin irregularities:
- Use barrier rings, stoma paste, or moldable seals to even out the surface.
- Some people cut a hole in hydrocolloid sheets and fit the pouch over them to create a flat platform.

5. Choose products designed for problem skin or uneven surfaces:
- Consider using Coloplast SenSura pouches with elastic adhesive, Marlen Deep Convexity system, or Salts Convex pouch with a Coloplast seal for a secure fit.
- Ostomy spray adhesives can provide extra grip.

6. Skin protection and healing:
- Try the “crusting” method by alternating layers of stoma powder and adhesive spray to form a smooth, sealed surface.
- Use stoma powder on raw or weeping skin, then seal with prep spray or wipe.
- For antifungal or irritated skin, ask the doctor about prescribing Nystop (nystatin) powder.
- Some find that applying calamine lotion on clean, dry skin, followed by a warmed baseplate and an ostomy belt, helps heal small raw spots quickly.
- If powder affects adhesion, consider using barrier films or prep wipes instead.

7. Change-time techniques:
- Eat lightly before changing to reduce immediate output.
- Let the area air-dry for a few minutes before applying a new pouch.
- Consider changing the pouch one day earlier than usual to allow the skin to heal.

8. Odor and output management:
- If odor is an issue during extended wear time, internal deodorant tablets like Devrom might help.

These suggestions involve various products and techniques that could potentially improve the situation.