This topic is about managing leaks for someone with an ileostomy that has a unique shape due to a small fistula. The stoma has an irregular, oval-with-notch opening, which can make it challenging to find the right fit for ostomy appliances. The output is very liquid, and leaks often happen, especially when sitting, as this can loosen the wafer. The person is currently using a Coloplast SenSura Mio one-piece system and has tried several techniques to improve adhesion. They are considering trying a more flexible wafer and are open to suggestions for better skin protection and healing.

Here are some helpful insights and advice:

1. Consider using oval wafers instead of round ones. They can better accommodate changes in body shape when sitting and may help reduce leaks caused by pulling.

2. Explore different brands:
- Hollister’s “New Image” and other flat barriers are made from soft, flexible bandage material, which might flex more than the plastic-backed SenSura Mio.
- Both Coloplast and Hollister offer moldable barrier rings. Eakin Cohesive Seals are another option. These rings can be stretched, folded, or V-notched to fit the fistula shape and often work better than paste with liquid output.

3. Tips for applying rings or O-rings:
- You can apply the ring directly to the skin or to the back of the wafer. Try both methods to see which provides a tighter seal.
- Warm the ring or wafer in your hands or with a hair-dryer before application to improve adhesion.

4. For skin protection and healing:
- Treat the weepy, red skin first. One method is using Domeboro Astringent Solution powder packets mixed with warm water. Apply soaked gauze or paper-towel squares for 15 minutes, then rinse and dry thoroughly. Start with daily changes to help the skin heal, and extend wear time once the skin is healthy.
- After the skin is dry, apply a protective barrier like Marathon or another barrier spray or wipe before attaching the wafer.

5. Check the stoma length. A 1-inch protrusion is favorable for liquid output. Ensure the wafer opening is cut close but not pressing on the stoma itself.

6. Consider reaching out to others with similar experiences. Connecting with someone who has a similar stoma-fistula situation can be a great way to exchange practical tips and support.