This topic is about a couple dealing with a challenging situation after the wife underwent surgery to create a temporary ileostomy. The stoma is deeply retracted, meaning it sits below the skin level, which is causing issues with leaks. They are seeking advice on products and techniques to manage these leaks effectively.

Here are some helpful insights and advice:

1. **Identify Stoma Level**
- If the stoma is flush with the skin, consider switching to a convex wafer. If it is truly retracted below the skin, consult with a surgeon or an Enterostomal Therapy (ET) nurse about the possibility of surgical revision.

2. **Try Deeper Convexity**
- Consider using a Coloplast SenSura Mio Deep Convex wafer, which is the deepest option available from Coloplast.
- Other options include the Hollister 11905 Soft Convex wafer or a Coloplast convex system with specific flange and pouch combinations.
- Hollister CeraRing Convex Barrier Rings might also be helpful.

3. **Consider Moldable or Pre-Sized Convex Barriers**
- These can help eliminate cutting errors. An example is the ConvaTec SUR-FIT Natura Durahesive Moldable Convex Skin Barrier.

4. **Barrier Ring Tips**
- Warm the ring before applying to improve its stretch and seal.
- Stretch or thin the ring so it fits snugly around the stoma. Some people prefer a thinner ring like the Hollister 8805.
- You can place the ring on the wafer or directly on the skin; both methods work, but many mold it to the wafer first when using convexity.
- If the ring swells and starts to obstruct, remove the pouch, clean away excess ring material, and reattach the pouch.
- Experiment with different brands as they swell differently.

5. **Alternatives to Thick Rings**
- Use Coloplast Strip Paste, flattened very thin, to fill gaps without adding height.
- Consider convex barrier rings instead of standard flat rings if more pressure is needed.

6. **Skin Protection & Application Routine**
- Clean the skin with warm water and ensure all adhesive remover is gone.
- The skin must be completely dry before applying the appliance. Some people use ostomy powder followed by a skin-prep wipe or spray.
- For extra protection, use products like 3M Advanced Skin Protectant or Marathon before applying the wafer if the skin is fragile.
- After applying the appliance, hold gentle pressure or use a warmed pack over the wafer to help set the adhesive.

7. **Measure Stoma Regularly**
- Measure the stoma at every change for the first six weeks and resize the opening as the stoma shrinks.

8. **Check for Interferences**
- Look for staples or abdominal folds that might interfere with the wafer seal. Leaks often stop once staples are removed.

9. **Dietary Considerations**
- Be mindful of evening foods that cause gas, such as broccoli, cabbage, and dairy, as they can increase nighttime output and leaks.

10. **Surgical Revision**
- If leaks persist and the stoma remains deeply recessed, discuss the possibility of a surgical "pull-through" revision with the surgeon. This is usually a minor procedure and might be considered before cancer treatment ends.