This topic is about finding the best way to cut a flange for a stoma that has an irregular shape. The person in question has a stoma that is wide and uneven, which makes it challenging to get a good fit with standard circular cut-outs. They are looking for advice on how to measure and cut the flange accurately to avoid leaks and skin irritation.

Here are some helpful tips and insights:

1. Customize the flange opening to match your stoma's shape.
- Use heavy paper or the wafer’s backing to press against the stoma and create an outline. This can serve as a template.
- Cut the opening slightly larger than the stoma to prevent constriction, allowing the barrier ring to fill any small gaps.

2. Create a reusable template for consistent cutting.
- Tape Method: Use semi-rigid plastic over the stoma, tape around it, lift off, trace, and cut a permanent guide.
- Food-Color Stamp: Dab food coloring on the stoma, press the non-stick side of the wafer to take an imprint, and trim until the hole is slightly larger than the imprint.
- Wire Method: Wrap soft solder or copper wire around the stoma to capture its contour, transfer to card or plastic, cut out, and reuse.
- Keep a spare template in a backup kit and redo the process if the stoma changes shape.

3. Consider trying moldable wafers.
- Both ConvaTec and Hollister offer moldable wafer systems, and you can request free samples to try them out.

4. Use barrier or moldable rings correctly.
- Stretch or roll the ring so it fits snugly against the stoma without exposing skin.
- You can either press the ring onto the wafer opening first or place it around the stoma before applying the wafer. Moldable rings are usually placed on the skin first.
- If the ring erodes quickly, cut the wafer closer to the stoma to protect the ring, as the wafer material is more durable.

5. Recommended products:
- Coloplast Brava Protective Seal, Item #12035, is known for stretching well, not tearing, and leaving no residue during removal.
- Coloplast Brava rings are also praised for their ease of stretching around large, oblong stomas.

6. Observe your stoma's shape in different positions (standing, sitting, lying down) and cut wider where the stoma flattens. A small gap of about 1/8 inch is acceptable for airflow and can be filled by the barrier ring.

7. Additional practical tips:
- Reuse the backing from your previous wafer as a tracing template for the next one, especially with 2-piece Coloplast systems.
- Use bag lubricant to prevent the pouch from sticking if the ring material bulges through the opening.