This topic is about dealing with persistent leaks from a new ileostomy, specifically when using the Hollister Soft Convex 11703 wafer, which is currently on back-order. Here are some helpful insights and advice for managing this situation:

- The ileostomy was created on October 11, and since then, there have been issues with leaks, even while in the hospital. The current setup involves changing the pouch twice a day, with nine changes over one weekend.

- The Hollister 11703 wafers are on back-order, and the substitute wafer is not performing any better. Both hospital and home-health nurses have struggled to achieve a secure seal.

- The best, albeit short-lived, result has been achieved by "turtlenecking" an Eakin Cohesive ring. This involves rolling it into a snake shape, circling the stoma, and adding extra pieces at the 9 o'clock and 3 o'clock positions to bridge a skin crease.

- The stoma is in line with the belly button and is very shallow, barely protruding above the skin. Frequent appliance changes have left the peristomal skin sore and irritated, and there is anxiety about running out of supplies over the weekend.

- There is a willingness to try paste and an ostomy belt. Despite the belly-button alignment, there is adequate flat skin for wafer placement. Both soft convex and flat wafers have been tried, but both leaked.

- Normally, cleaning is done with warm water only, as advised by a nurse, but adhesive-remover wipes have been reintroduced because the skin did not feel clean enough. The Eakin ring is warmed in the hands, but a hair-dryer has not yet been tried on the wafer.

Here are some general sealing techniques and product suggestions:

1. Cut the wafer opening to fit snugly around the stoma with no skin showing. Apply firm pressure or use a support belt for 5–15 minutes after placement.

2. Run a fingertip around the inner edge of the wafer once it's on to ensure a tight seal, then hold a warm hand over the adhesive for several minutes. Some people pre-heat the wafer with a hair-dryer set to low.

3. Always place appliances on clean, completely dry skin. Avoid soaps with lotion, dyes, or perfume. Cetaphil bar soap and warm-water rinses are recommended.

4. Let the skin "air out" briefly during changes and minimize the frequency of changes to limit irritation.

Products and accessories that have helped others include:

- Barrier rings like Eakin Cohesive, Coloplast Brava 11443, and Coloplast Barrier Ring #120467.

- Ostomy paste such as Hollister Adapt or Coloplast Brava, used either instead of or in addition to rings.

- Brava Elastic Barrier Strips to reinforce wafer edges.

- Convex appliances for low/flush stomas, like the Hollister convex pouch #82711, have been cited as effective. Request free convex samples from Hollister, Coloplast, and ConvaTec.

- Skin prep/protective films like Hollister Skin Barrier Spray and Hollister 7760 (Adapt Stoma Powder) can be used sparingly on irritated spots. Wipe off excess powder before applying the wafer.

- Adhesive remover wipes or spray for gentle wafer removal. Push the skin down while peeling to prevent trauma.

- Hypafix tape for extra edge security between full changes.

- Always wear an ostomy belt to keep the system snug against the abdomen.

Application and removal tips:

- Warm barrier rings with hand heat or a hair-dryer so they mold easily. Some stretch the ring over a 1-inch tube, align it perfectly with the wafer hole, then transfer it to the skin.

- Shower without equipment to cleanse the area, collecting output in a disposable cup if needed. Pat dry, don’t rub.

- Shave or clip peristomal hair carefully with an electric razor or new blade to improve adhesion.

- When removing, use adhesive remover to loosen a corner, then let the wafer "fall away" rather than pulling it off.

Troubleshooting and support:

- Leaks often stem from an appliance–stoma mismatch. Keep trying different wafers and rings until a reliable combination is found. Manufacturers will overnight free samples.

- Contact Hollister, Coloplast, or ConvaTec product support teams. They have ostomy nurses who can advise and expedite supplies.

- If weekend supplies run low, many items like barrier rings, remover spray, and belts can be bought on eBay or at local pharmacies as a stop-gap.

Encouragement:

- Leaks are common in the first months. Most users eventually achieve 4- to 7-day wear times after refining their routine. Staying patient and systematic in testing products is key.