This topic is about dealing with persistent leakage issues when using a Hollister 2-piece ostomy appliance with an Adapt barrier ring. Despite multiple attempts by nurses, the system continues to leak, and the person is looking for practical solutions. Here are some helpful suggestions and insights:

1. Consider trying different manufacturers or systems:
- Coloplast SenSura Mio pouching system.
- Convatec 2-piece Durahesive wafer with Eakin Cohesive Seals, which many find effective against leaks.
- Coloplast pouch with Eakin Seals and Brava Elastic Barrier Strips, especially recommended for urostomy users.

2. Use accessory products to reinforce the seal:
- Apply Brava Elastic Barrier Strips (Coloplast) over the flange for extra security.
- Use medical tape around the flange if needed to keep it in place.
- A convex wafer or convex insert might help prevent leaks around a loop stoma.

3. Belt recommendations:
- The Convatec ostomy belt, part #175507, is noted for comfort and can be used with any 2-tab flange.
- Wearing a belt can provide gentle pressure, aiding healing and flattening of the abdomen.

4. Skin preparation and protection:
- Clean peristomal skin with oil- and perfume-free soap or just water, avoiding shampoo residue.
- Thoroughly dry the stoma, warm the ring and wafer slightly with a hair-dryer, then apply.
- Use a wipe-on or spray-on skin barrier prep before attaching the wafer.
- For inflamed skin, dab liquid antacid (like Mylanta), let it dry, then apply a skin barrier film before the wafer. Healthy skin helps improve adhesion and reduce leaks.

5. Application techniques:
- Ensure the wafer opening closely matches the stoma size to prevent leaks.
- Mold or stretch the barrier ring to fit snugly around the stoma, pressing firmly for about a minute. Using a short length of PVC pipe or similar sleeve can help apply even pressure.
- Change the entire system regularly (e.g., weekly) to prevent skin damage.

6. Troubleshooting tips:
- Early post-op swelling and uneven skin can cause temporary leaks; time and proper compression with a belt often improve the situation.
- Shampoo or body-wash residue can affect adhesion; if unsure, re-shower without soap before applying a new appliance.
- Contact Hollister’s product support team for specific troubleshooting and sample alternatives.

7. Professional help:
- If leaks continue, consult with a WOCN-certified nurse (different from general RNs) to assess the need for convexity, belt fit, and a skin treatment plan.