This topic is about someone who is having trouble getting a good fit with their new two-piece ileostomy appliances. The poor fit is causing skin irritation around the stoma, which is uncomfortable and sometimes painful. They are looking for advice from others who might have faced similar issues and want to know how to improve the fit and comfort of their appliance.

Here are some helpful tips and insights:

1. Check the opening size:
- Ensure the hole in the wafer or pouch is not too large, which can cause leakage, or too tight, which can lead to pain, bleeding, and redness.
- Leave a small clearance, about 1/16 inch, so the stoma can expand and move without putting stress on the wafer.

2. Consider cut-to-fit options:
- Use cut-to-fit or "custom cut" pouches instead of pre-cut sizes.
- Some products, like Hollister stomahesive wafers, come without an opening. Use the supplied measuring card and hole-punch to create the exact size you need. Pre-cut several wafers in advance for convenience.

3. Improve the seal:
- Apply a barrier, such as stoma paste or a moldable barrier ring, before attaching the appliance to fill gaps and prevent leaks.
- Some people place a barrier ring first, then the wafer/pouch, while others prefer a one-piece drainable pouch with a barrier ring for fewer steps.

4. Use the template technique:
- Trace a correctly cut wafer onto the plastic backing with a Sharpie to create a reusable template. This ensures every new wafer is cut the same, even for irregularly shaped stomas.

5. Take care of your skin while healing:
- Dust irritated skin with stoma powder, then seal it with a barrier spray or wipe.
- Give the stoma and surrounding skin some "air time" by lying on a towel without the appliance for a short period to let the area dry and heal.

6. Try different brands and products:
- Contact major manufacturers for free samples to find what fits best. Some mentioned brands include Hollister and Coloplast.
- Users have reported that Coloplast products with barrier rings can last up to 7 days without leaks, while Hollister wafers sometimes lasted only 2 days before issues arose.

7. Seek additional support:
- Manufacturer helplines, like Coloplast's, often provide quicker and more detailed product advice than some busy stoma nurses.
- Online support groups can offer practical tips and personal experiences when professional help is hard to reach.