This topic is about managing a recessed or "innie" stoma after a hernia repair surgery. The person sharing their experience is dealing with some challenges and is looking for advice on whether to use a one-piece or two-piece appliance system. Here are some helpful insights and advice from others who have faced similar situations:

1. Recessed or flush stomas often need surgical revision:
- Many people find that a stoma sitting at or below skin level can lead to leaks and skin damage. A long-term solution is to have revision surgery to raise the stoma at least ¾ inch above the skin.
- It's important to consult a surgeon who specializes in stoma creation and ask about their experience and outcomes.
- Revision surgery can sometimes be a simple outpatient procedure, but if there are adhesions, it might require a longer hospital stay. The benefits include easier appliance changes and improved quality of life.

2. Interim pouching options while considering surgery:
- Consider trying convex systems designed for recessed stomas. Some have had success with products like the Coloplast “light convex” two-piece Click barrier and pouch.
- Convex two-piece setups can be convenient because they allow you to briefly "burp" the seal to release gas.

3. One-piece vs two-piece considerations:
- If the one-piece appliance was more comfortable and held better, it might be worth returning to it.
- Rinsing the pouch is not necessary. Using a lubricating deodorant and changing the bag every 3–4 days can help avoid the need to rinse.

4. General management tips:
- Use seals or rings under any wafer to improve adhesion.
- Address skin irritation quickly, as persistent ulcerated skin indicates that the current setup is not working.
- If the initial surgeon cannot resolve the problem quickly, consider seeking a second medical opinion.