This topic is about managing a concave stoma that is 90 days old and sits below skin level. The person is concerned about potential skin irritation because they are using pouches designed for protruding stomas, which might not be the best fit for their situation. They are looking for practical advice and product recommendations to protect the skin around the stoma.

Here are some helpful suggestions and insights:

1. Consider using convex options from both Hollister and Coloplast. These might help with leakage issues, although they may not completely solve the problem for a deeply recessed stoma.

2. An ostomy belt can be added to help press the wafer snugly against the body, which has been reported to reduce leaks.

3. To build up a flat surface:
- Start with a convex wafer.
- Cut two rings out of a flat wafer, punch stoma-sized holes, and stack them on the wafer.
- Place an Adapt Convex Barrier Ring from Hollister directly against the skin.

4. Use barrier rings creatively by tearing pieces to fill skin folds or irregular gaps.

5. Cut the wafer opening slightly larger than the stoma to prevent pressure and tearing when the output is thick.

6. Try the double-underwear support method:
- The first tight pair acts like a belt; cut a hole just smaller than the wafer seal and reinforce it with seam-binding lace.
- The second pair holds the pouch’s weight to prevent it from peeling away, even when full.

7. For seal security, use Hy-Tape (pink waterproof tape) around the wafer if there is no tape allergy. This helps the system stay in place during activity or when the output is heavy.

8. For skin protection during frequent changes or irritation:
- Use the "crusting" technique, which involves layering stoma powder with skin-prep to form a protective film.
- Use spray adhesive remover to gently lift wafers and prevent skin damage.

9. Manage output by striving for consistent stool to reduce "pancaking" under the wafer. Some users eventually turn to colostomy irrigation when feasible.

10. Be cautious with thick oval barrier rings that can fold in heat, as they may collapse and block output when sitting. Test products in daily positions.

11. One member tried using 4 × 4 adhesive squares, but they did not improve sealing on a concave stoma.