This topic is about finding the best way to prevent leaks when switching from convex to flat ostomy bags. The person sharing their experience usually uses a convex wafer with a barrier ring, which helps guide the stoma output directly into the pouch. However, after some leakage issues, their stoma nurse suggested switching to flat bags. This change led to more leaks, so they are considering using a convex or standard barrier ring under a flat wafer to recreate the needed convexity. They are seeking advice from others who might have tried similar solutions.

Here are some helpful insights and advice shared by others:

1. Many people successfully use a moldable barrier ring under a flat wafer, which works well for them, especially with a colostomy.
2. True convex wafers are often the most reliable for flush or low stomas. It's important for nurses to explain why they might advise against using them.
3. One person found success by adding a plastic convexity insert ring inside a flat flange, creating a slight convex effect without using a full convex wafer.
4. A member with a nearly flush stoma used barrier rings with convex wafers to eliminate leaks. With a better-protruding stoma, they now use a barrier ring with a flat wafer without issues.
5. Another person temporarily stacked a convex ring under a convex wafer during a bad leak phase, which stopped the leaks. They later switched to a thinner ring once their skin improved.
6. Someone using a one-piece closed flat pouch found success without any rings or inserts by using a protective skin barrier prep and warming the pouch with a hair-dryer before applying it.
7. It's emphasized that the choice of appliances is highly individual. It's important to use whatever combination keeps the skin healthy and prevents leaks, regardless of general nursing preferences.
8. Practical tips include:
- Heating the wafer or ring with a hair-dryer to improve moldability and adhesion.
- Asking the nurse for the specific reason behind discontinuing convex wafers, as some clinics discourage them only in special circumstances.
- Ensuring the peristomal skin is completely flat and the stoma protrudes at least 1 cm before committing to flat wafers alone, as some degree of convexity is usually needed otherwise.