This topic is about dealing with persistent leakage from an ostomy, which can lead to raw skin and the need for frequent appliance changes. Here are some helpful insights and advice for managing these challenges:

- The stoma was created in June 2014 due to a radiation-related obstruction and was revised to enlarge and raise it. However, it sits at the waistline where the abdomen bends, causing constant leakage and skin irritation.

- The current care routine involves washing with warm water, drying with a hair-dryer, using stoma powder, applying a skin-barrier spray, and then applying the wafer. Despite having a variety of products, nothing seems to stop the leaks.

- The surgeon suggests using a barrier ring without powder or paste to help the skin heal and recommends a high-fiber diet to thicken the stool, although medication may keep it loose.

Here are some strategies to consider:

1. Seek a second opinion or consider stoma re-siting. Improper placement can be a root cause of issues, so consulting another specialist might help.

2. Focus on treating and protecting damaged skin before aiming for better adhesion. Using a liquid antacid can soothe the skin, and a dermatologist-prescribed solution can calm inflammation.

3. Fill creases and flatten the surface using strip paste or barrier rings to create a more even base for the appliance.

4. Reinforce the outer edge with products like Coloplast Brava Elastic Barrier Strips to help hold everything in place.

5. Once the skin is healthy, consider switching to a convex system, which can help reduce leakage by improving the stoma's angle.

6. A step-by-step leak-control technique involves preparing the wafer the night before and using a combination of paste, seals, and powder for better adhesion and longer wear time.

7. For liquid output, consider medication or dietary adjustments under medical guidance to thicken the stool.

8. Colostomy irrigation might be an option to reduce output and give the skin a chance to heal.

9. General application tips include warming the wafer before applying and lying down to reduce abdominal creasing.

These suggestions involve various products from manufacturers like Coloplast, Hollister, Convatec, and Eakin, which offer different solutions to help manage ostomy care effectively.