This topic is about managing early leakage issues with a Hollister 2-piece ileostomy system. The person is experiencing frequent leakage just three weeks after their ileostomy surgery. Here are some helpful tips and advice to address this issue:

- Consider replacing the paste with a barrier ring or seal. Options include Hollister Adapt Barrier Ring, CeraRing, Coloplast Brava Protective Seal, and ConvaTec Eakin Cohesive Seal. These rings are more resistant to liquid breakdown than paste. Cut the ring slightly smaller than the stoma to ensure a snug fit. Some people use a second ring on top of the wafer for added protection.

- When cleaning and preparing the skin, remove the wafer slowly using adhesive-remover wipes instead of peeling it off dry. Make sure to eliminate all residual adhesive before reapplying. Wash your hands and the skin around the stoma with fragrance-free, moisturizer-free soap or just warm water. Rinse thoroughly and pat completely dry, as moisture or soap residue can weaken adhesion. Some people use skin-prep wipes followed by Torbot’s Skin-Tac, allowing each layer to dry fully before applying the ring or wafer.

- Ensure the wafer hole is the correct size and consider using convex wafers if needed. A new stoma can change size, so reassess and recut the opening often. If leaks continue, request convex or moldable wafers from Hollister, Coloplast, or ConvaTec, as they offer free samples.

- Support belts and positioning can help. A clip-on Hollister elastic belt or a wider Nu-Hope belt can keep the appliance firmly against the abdomen, which is especially helpful when leaning or transferring from a wheelchair. Warm the wafer against your body for a minute before application, then hold it in place for another minute after attaching.

- To prevent back-wash, empty the pouch more frequently, as ileostomates often empty 6-10 times a day. Avoid letting output or gas build up to the point where it can push under the wafer. Sleeping or sitting in a way that causes the pouch to fold upward can also cause backflow, so use a belt or fabric pouch cover to keep the bag hanging straight.

- When comparing products, Eakin seals are gentler on the skin but less durable, while Brava seals last longer but may require extra remover wipes due to their strong adhesion.

- If problems persist, take photographs of leaks before removing the wafer to identify where they start. Consult an ostomy nurse at a local hospital or through a manufacturer helpline for a hands-on assessment and to explore convex options.