This topic is about dealing with persistent leaks and skin issues for someone with a nearly-flush sigmoid colostomy. After emergency surgery for ruptured diverticulitis, the person’s husband is experiencing challenges with his stoma, which sits almost flush with the skin. This has led to leaks and skin irritation. Here are some helpful tips and advice to manage these issues:

1. Skin Healing and Protection
- Allow the skin to air-dry, then apply Maalox antacid to raw areas and dry with a hair dryer before putting on the wafer.
- Use Stomahesive or other ostomy powder, dust off the excess, and seal with a “no-sting” barrier spray like Cavilon or Salts Peri-Prep wipes.
- If the skin is weepy, consider soaking in a warm bath first.
- Use Coloplast 4"×4" skin barrier sheets or other barrier sheets/tape to protect allergic skin under any wafer.

2. Product Selection and Fitting
- A nearly flush or retracted stoma often requires convexity; try samples from Hollister, Coloplast, and Convatec.
- For a hard or flabby abdomen, use a stiffer two-piece appliance; for a firm abdomen, a softer appliance may work better.
- Convatec moldable two-piece flanges with Combihesive Disposable Convex Insert can mold tightly to oval stomas without cutting.
- Mold an Eakin Cohesive ring onto the wafer first, pinching the edges closed; small Eakin “plugs” can be placed in skin creases.
- Some find better seals by layering: barrier ring, thin bead of stoma paste, and convex wafer.
- Warm the wafer/ring to body temperature before application, then apply firm hand pressure for 5–20 minutes; walking or lying flat afterward can help prevent creasing.

3. Belts and Support Garments
- Use an ostomy belt clipped to the wafer, a hernia belt, an abdominal binder with a hole, or a Sash Hernia Support belt to improve convex pressure and keep edges down.

4. Application Techniques
- Thoroughly dry the skin with a hair dryer on low; avoid soap or body-wash residues before changes.
- Hold the wafer firmly and add medical tape around the edges for extra security.
- Avoid eating or drinking for 30–60 minutes after applying to limit immediate output; eating marshmallows 15–20 minutes before a change can slow output.

5. Adhesive Aids and Removal
- Use stoma bond/glue only as a last resort, as it can be harsh on the skin.
- Lift Plus Medical Adhesive Remover eases painless flange removal without affecting new adhesion.

6. Output Management and Diet
- Use Adept Lubricating Deodorant inside the pouch and Absorba-Gel squares to help output slide and thicken.
- A high-fruit/high-water diet keeps stool loose for colostomies; others prefer starches like pasta to thicken when going out. Limit acidic foods and caffeine if output is corrosive.

7. General Tips
- Keep emergency supplies, towels, and wipes handy for sudden leaks.
- Work closely with stoma nurses; weekend on-call teams can provide real-time troubleshooting.
- Trial and error is normal—once the right product and routine are found, long leak-free periods are achievable.