Topic Explanation:

The forum discussion revolves around a new user seeking advice on dealing with colostomy wafer leakage. The user has been home from the hospital for two weeks and is experiencing issues with the Hollister flextend wafer not adhering properly to their skin, leading to leakage. They are looking for guidance on what might be going wrong and how to improve the situation.

Advice and Insights:

1. Skin Preparation:
- Ensure the skin is clean and dry before applying the wafer. Avoid soaps with dyes, lotions, or fragrances as they can affect adhesion. Cetaphil soap is recommended.
- Use a warm, wet washcloth to clean the area and ensure it is completely dry before application.

2. Product Selection:
- Experiment with different products and brands, such as Coloplast, ConvaTec, and different types of Hollister wafers (e.g., convex versus regular).
- Request free samples from manufacturers to find the best fit.

3. Application Techniques:
- Use a blow dryer to warm the wafer for about 30 seconds before applying it to enhance adhesion.
- Hold the wafer in place firmly with your hand for a couple of minutes after application.

4. Barrier Rings and Flange Extenders:
- Barrier rings can help improve the seal and prevent leaks.
- Flange extenders, which are U-shaped strips, can be used around the edges to secure the appliance better.

5. Support Belts:
- Consider using a support belt, like the Nu-Hope belt, especially if you have a parastomal hernia.

6. Stoma and Wafer Fit:
- Ensure the stoma protrudes at least 3/4 of an inch. If it retracts, consider using convex wafers.
- The skin around the stoma should be flat without creases or bulges.

7. Pancaking Issues:
- Pancaking occurs when stool sticks to the top of the bag, potentially causing leaks. Solutions include adding oil or lubricant to the bag and trapping some air inside.
- Regularly clean the area if pancaking occurs.

8. Additional Tips:
- Use a skin prep to help with sore skin and improve adhesion.
- Be patient and take your time during changes to ensure proper application.
- As the stoma may shrink over time, adjust the size of the bag