This topic is all about finding the best way to measure a stoma that isn't perfectly round, so you can cut a wafer that fits just right. The usual cardboard guides that come with pouches are too round and can leave gaps, while moldable wafers might lead to leaks. The aim is to create a reliable method for making a custom-cut opening that matches an irregular stoma shape, preventing leaks and skin irritation.

Here are some helpful tips and insights:

1. Cardboard templates are often too round, so consider looking for custom-cut alternatives.

2. To measure an oval stoma, use the measuring ruler printed on the box insert. Measure both the horizontal and vertical diameters, then use the concentric rings on the wafer to guide your cutting.

3. You can trace directly on the wafer’s clear plastic backing. Fit one side, mark any mismatches with a felt-tip pen, trim, test, and refine. Once you get it right, save the backing as a permanent template.

4. Consider buying oval template sheets from an art or craft store for more precise cutting.

5. An Eakin Ring or Hollister Adapt ring can be formed around the stoma. Lift it off intact and trace that shape onto plastic to create a custom template.

6. Warm an Adapt or Eakin ring with a hair dryer on low heat for about 20 seconds to make it stretch more easily. Stretch it to match the longest stoma dimension, apply it directly to the skin, and seat the wafer on top. This helps seal gaps and allows you to order wafers pre-cut to the ring’s largest size.

7. Some people prefer the wafer or reinforcing seal to just touch the stoma all around, with no intentional gap, to minimize leakage and protect the skin.

8. Others fill gaps with stoma paste, finding it easier to mold to odd shapes than rings. They also find paste removal manageable during cleaning.

9. For extra security and longer wear time:
- Clean and dry the skin thoroughly, dust with adhesive powder, spray with 3M Cavilon barrier, apply the wafer, and reinforce edges with Opsite tape.
- Use a medical aerosol adhesive on the flange before application for added stickiness. It's noted to be non-irritating and waterproof.

10. Keep an eye on your body chemistry. Low potassium levels can cause the skin to "weep" and shorten wear time. Restoring potassium levels helped one user with adhesion issues.

11. Remember that stoma shapes can change over time, so re-measure periodically and keep multiple template sizes on hand.