Managing leakage and skin irritation with a retracted colostomy stoma can be quite challenging, especially for an 80-year-old who recently underwent an emergency colostomy. The stoma is retracted, sitting in a shallow "bowl," which leads to frequent leaks and severe skin irritation around the stoma. Here's a look at the current care routine and some advice and insights that might help improve the situation:

- The current routine involves using a 2-piece Coloplast convex wafer system with a Coloplast convex barrier ring. When the skin breaks down, Marathon liquid skin protectant is used; otherwise, stoma powder and skin prep are applied. Despite assistance from an ostomy nurse, the wear-time rarely exceeds 30 hours.

- Further surgery is not an option due to limited stoma length caused by poor blood flow related to colon cancer. The caregiver is also unfamiliar with colostomy irrigation and barrier wipes.

Here are some suggestions and insights from others who have faced similar challenges:

1. Surgical revision is considered a definitive fix by some, involving stomal revision or lengthening by a colorectal surgeon. However, this is not an option in this case.

2. It's advised to explore non-surgical options first, especially given the surgical risks for elderly individuals.

3. Barrier wipes or sprays can be beneficial. Using skin-protective wipes like ConvaTec Esenta or Coloplast Brava before applying the wafer can help protect the skin and improve adhesion.

4. Consider changing product configurations. Switching from a convex barrier ring to a flat ring while keeping a convex wafer might help, as excess thickness can lift the seal. Moldable convex wafers that hug the stoma without cutting, paired with flat rings, are also worth trying.

5. Warming the wafer with a hair dryer on low and pressing firmly all around can improve adhesion. Adding an ostomy belt and using barrier extenders if edges lift can also help.

6. Request free samples of moldable barriers and flat rings from suppliers like Coloplast and ConvaTec. Some users find 3M Cavilon Advanced Skin Protectant more durable than Marathon.

7. Wear-time expectations vary, with some achieving 2–7 days with successful seals. Others change every other day or achieve 4 days before the moldable barrier breaks down.

8. Consider exploring colostomy irrigation in the future to reduce output and leakage frequency.

9. For ancillary skin care, daily or every-other-day "naked" showers can cleanse the skin. On non-shower days, Medline Remedy Phytoplex Cleanser No-Rinse Foam is recommended.

10. Personal experiences vary, with some managing leaks using hard convex barriers and daily changes, while others found revision surgery resolved the problem long-term.