This topic is about finding ways to extend the wear time and prevent leaks when using Hollister flanges on a flat ileostomy stoma. The person sharing their experience has a stoma that is flat and close to a slowly-healing surgical wound, which makes it challenging to keep the flange in place. They are looking for advice on how to improve adhesion and use Hollister’s spray adhesive correctly. Here are some helpful tips and insights shared by others:

1. If you have sensitive skin, try using "dry-on-dry" skin preparation:
- Wash the area with additive-free Ivory soap.
- Avoid using lotions or powders unless you are treating sores.
- Make sure your skin is completely dry before applying the flange. Warm the flange and press it by hand for 10–15 minutes to ensure a full bond.

2. For skin comfort and to relieve minor itching:
- Rub a freshly crushed aloe-vera leaf on the skin around the stoma and let it air-dry completely.

3. General tips for seating the flange:
- Warm the baseplate using body heat or a hair-dryer on a low setting.
- Ensure the area is flat and wrinkle-free before attaching the pouch.
- Cut the opening to fit exactly rather than stretching it.

4. Consider trying alternative appliances or brands:
- Coloplast Assura 2-piece has a rigid baseplate that prevents kinks and allows visual alignment before attaching the pouch.
- Convatec offers one-piece or two-piece options, including a new mouldable convex flange, known for long wear and strong customer support.
- Hollister 14803 (hard shell) baseplate with an Adapt flange or barrier ring is suggested for retracted stomas.
- Covetec flange, used with Skin-Tac and paste, has shown good results.

5. Use barrier rings, seals, and powders:
- An Eakin seal under the Hollister flange can help stop leaks.
- Adapt barrier rings are also recommended.
- Karaya gum powder, layered with Skin-Tac or 3M/Cavilon Skin Prep spray, can create a dry protective crust before applying the flange.

6. Paste techniques:
- Apply ostomy paste around the stoma and on the flange opening. Let it tack-dry before pressing the flange in place.

7. Support or hernia belts:
- Use an inexpensive back-support or hernia belt. Cut a hole for the plastic coupling, pull the pouch through, and fasten it snugly. This can prevent the edges from rolling up and may help a flat stoma protrude more over time.

8. Protecting irritated or wounded skin:
- Apply a thin coat of calamine lotion or unflavored Maalox and dry thoroughly with a cool hair-dryer.
- Use ConvaTec DuoDERM Extra Thin patches over sores; Hollister flanges adhere to them.
- A thin clear protective film can keep flange adhesive off an adjacent wound.
- Allow Polysporin Quick Drying Antibacterial Cream or calamine to dry fully before reapplying an appliance.

9. Emphasize patience in your routine:
- Take extra time during each change for skin care and full drying. Rushing can lead to leaks and worsen skin issues.