This topic is about dealing with persistent leaks and skin irritation for someone with a new ileostomy. The person initially used a convex flange but switched to a flat one due to skin issues, only to experience more leaks. They are now back to using the convex flange, which helps with leaks but may cause skin problems. Here are some practical tips and insights to help manage these challenges:

- Ensure the stoma protrudes adequately, ideally about 19 mm (¾ inch) beyond the skin. If it is too short and leaks continue, consider consulting a surgeon for a possible revision.
- Identify where the leaks start. It could be due to uneven skin, the contours of a hernia, or insufficient stoma protrusion. Understanding the cause can help prevent full blowouts.
- Use a barrier ring to improve the seal. Many people find that this alone can stop leaks. Salts Aloe Barrier Rings are a popular choice in Canada.
- Clean the skin with non-oily, residue-free soaps like DIAL or IVORY to ensure the wafer adheres properly.
- Make sure the skin is completely dry before applying the flange. You can use a blow-dryer on a low setting. If using stoma powder, apply a light dusting and seal it with skin-prep wipes before attaching the wafer.
- Continuously assess whether a convex or flat barrier is more suitable for the hernia’s contour. Convex barriers often help prevent leaks when the peristomal area is raised.