Topic Explanation: Dealing with Leaks and Skin Issues in Ostomy Care

The discussion centers around managing leaks and skin irritation in ostomy care. The original poster is experiencing output leakage under the barrier ring, leading to painful skin stripping. Despite following a cleaning and application routine, the issue persists, and the ostomy nurse has not provided adequate guidance. The poster is seeking advice on how to prevent leaks and heal the irritated skin.

Advice and Insights:

1. Identify Leak Source:
- Determine where the leak starts when removing the barrier.
- Consider skin texture and stoma position (flat, rounded, below, even, or above skin level).

2. Skin Healing:
- Use stoma powder and a membrane barrier to help skin heal.
- Keep the skin dry and free from contact with output.

3. Product Recommendations:
- Consider switching from a flat to a convex barrier ring, which may prevent leaks better.
- Try different products like Coloplast barrier rings, Mio Click bags, and convex devices.
- Use paste to fill in skin folds or grooves for better adhesion.

4. Application Techniques:
- Practice crusting techniques with stoma powder.
- Use micropore tape over raw skin before applying the appliance.
- Ensure the sealing ring fits around both stoma openings if applicable.

5. Alternative Products:
- Try New Skin-skin tac, rapid dry wound gel, or Marathon no-sting cyanoacrylate skin protection for raw areas.
- Consider Mio flip for round bellies or soft tummies.

6. Advocacy and Support:
- Be proactive and assertive with healthcare providers for better support.
- Engage with community forums for practical advice and shared experiences.

7. Additional Tips:
- Use a belt to support the bag if the weight is bothersome.
- Precut wafers and warm up rings before application to improve fit.
- Experiment with different products and techniques to find what works best for individual needs.