This topic is about the use of wafer extensions for ostomy care, particularly when dealing with a stoma located in a challenging spot, like in the middle of an abdominal roll. The person in question has been using these extensions for added security but is experiencing skin irritation as a result. They are seeking advice on whether these extensions are necessary and if relying solely on the wafer's adhesive might be a better option.

Here are some helpful insights and advice:

1. Try before you buy. Request free samples of barrier strips or extensions from different companies to find the most comfortable and effective option for you. Some products to consider include Coloplast Brava Elastic Barrier Strips, Hollister Adapt CeraPlus Barrier Extenders, ConvaTec Ease Strips, and Entrust Crescent Barrier Extension.

2. Be aware of allergic reactions. Itching or rashes can occur with any brand, including Hollister, Coloplast, and ConvaTec. If you notice redness, stop using the extenders.

3. Less is best. If you can get 4–5 days of reliable wear without leaks, consider skipping the extensions and trusting the wafer adhesive.

4. Consider gentler alternatives for your skin:
- Use skin-friendly tapes like 3M Micropore or Leukoplast Cover-Roll Stretch, which are flexible and water-resistant.
- Opt for pouches with an integral tape collar.
- Use ostomy belts, wraps, or vests to reduce tension as the pouch fills.

5. Pay attention to technique:
- When removing extensions, press the skin down while peeling them off, and use adhesive remover spray or wipes.
- Avoid changing extensions too frequently (every 1–2 days) or leaving them on for too long (beyond 4–5 days) to prevent skin irritation.
- Clean off any leftover adhesive thoroughly.

6. If your skin is already irritated:
- Soak the area with a Domeboro powder solution or another astringent for 15–20 minutes at each change, and rinse before applying a new appliance.
- Allow your skin to rest by avoiding unnecessary products until it heals.

7. Special situations:
- Extensions can provide extra security for activities like swimming or to extend wear time by an extra day.
- Consider wafers designed for uneven or rolled abdomens, such as those offered by Coloplast, to improve adhesion without additional tape.

8. The general consensus is to use extensions only if leakage or wafer edge lift is a proven problem. Otherwise, rely on the baseplate and use a belt or tape as needed.