This topic is about finding ways to improve the adhesion of an ostomy wafer on a sunken or uneven abdomen. When the area around the stoma is not flat, it can cause the wafer to lift, leading to leaks and frequent changes. Here are some helpful tips and advice to manage this situation:

1. Consider using a convex product or a wafer designed for uneven skin:
- Products like the Hollister CeraPlus convex wafer can help as they are slightly raised.
- One-piece convex systems generally work better on irregular abdomens to prevent leaks.
- If the stoma is close to skin level, using convexity along with gentle pressure from a support belt can improve the seal.

2. Instead of half-moon strips, try a full circular barrier ring, or apply the ring directly to the wafer so it reaches the edge of the opening before applying it to the skin.

3. Think about using stoma paste:
- It acts as a gap-filler in dips and around the stoma, often sealing better than rings.
- Apply a thin bead to the wafer or around the stoma, using gloves if needed.
- Paste is easier to clean off than rings and leaves less sticky residue.
- Be mindful that it softens in a hot shower, so check the seal afterward.

4. For irritated peristomal skin, follow this skin-prep sequence: use a barrier wipe, apply stoma powder on raw spots, then apply the wafer, ring, or paste.

5. Use an ostomy support belt to maintain pressure and keep the wafer flat:
- You can find manufacturer-specific belts that clip to the pouch or universal belts from places like Nu-Hope Corporation, with many affordable options available online.
- Most insurers will cover a support belt, and free samples are often available from manufacturers.

6. Build an emergency stock of supplies:
- Ask your prescribing clinician to authorize the maximum monthly quantity, such as 20 wafers and 20 bags, even if you usually use fewer.
- Keep ordering at the maximum until you have a comfortable surplus.
- Avoid using personal supplies when hospitalized, as the hospital should provide them.
- If needed, buy extras out-of-pocket; Canadian users mention ostomydepot.ca as a low-cost source.

7. Obtain free samples and professional guidance:
- All major manufacturers like Coloplast, Hollister, Convatec, and Nu-Hope offer samples and have ostomy nurses available by phone or online.

8. Check the wafer opening size: cut the hole just large enough to fit snugly around the stoma, as cutting it too wide can lead to leaks.