Getting your ostomy appliance to fit better can significantly improve comfort, reduce the risk of leaks, and protect the skin around your stoma. Here are some steps to help ensure a better fit:

1. Measure Your Stoma Regularly

• Measure Frequently: Especially in the weeks following surgery, your stoma size and shape may change. Measure your stoma every time you change your appliance to ensure a proper fit.
• Use the Right Tools: Use a measuring guide or template that often comes with your ostomy supplies to measure your stoma accurately.

2. Choose the Right Appliance for Your Stoma

• Size and Shape: Select an appliance that matches the size and shape of your stoma. The opening should be about 1/8 inch (3-4 mm) larger than your stoma to avoid irritation but snug enough to provide a good seal.
• Convex vs. Flat Wafers: If you have a stoma that is flush with the skin or retracted, a convex wafer might provide a better fit by gently pushing the stoma out, allowing for a more secure seal.
• One-Piece vs. Two-Piece Systems: Decide between a one-piece or two-piece system based on your comfort and ease of use. Some people find that one-piece systems are less bulky and provide a more secure fit, while others prefer the flexibility of two-piece systems.

3. Prepare Your Skin Properly

• Clean and Dry Skin: Clean the skin around your stoma with warm water and a soft cloth; avoid using soaps with moisturizers or oils, as these can prevent the adhesive from sticking. Make sure the skin is completely dry before applying the appliance.
• Use Barrier Wipes or Sprays: Applying a barrier wipe or spray can help protect the skin and create a smooth surface for the adhesive.

4. Cut or Mold the Wafer to Fit Your Stoma

• Custom Cut: Use scissors to cut the wafer opening to fit your stoma precisely. Some wafers can be molded with your fingers to create a snug fit.
• Pre-Cut Options: If your stoma size is stable, you may prefer pre-cut wafers that match your stoma size, reducing the need for cutting.

5. Apply the Wafer Correctly

• Smooth Out Wrinkles and Bubbles: When applying the wafer, smooth out any wrinkles or bubbles to prevent leaks. Press around the stoma to ensure a secure seal.
• Warm the Wafer: Warm the wafer with your hands for a few minutes after applying it. The warmth helps the adhesive bond better to the skin.

6. Use Ostomy Accessories for a Better Fit

• Barrier Rings or Strips: Barrier rings or strips can fill in gaps, creases, or uneven areas around your stoma, providing a better seal and fit.
• Ostomy Paste: Ostomy paste can also be used to fill in gaps and creases around the stoma, helping to prevent leaks and protect the skin.
• Ostomy Belts: Some people find that using an ostomy belt can provide additional support and keep the appliance snug against the body.

7. Consider Your Body Contours and Movements

• Adapt to Body Shape: Depending on your body shape or the location of your stoma, you might need to experiment with different types of appliances or accessories to get a better fit.
• Position and Movement: Be mindful of how your body position and movements (like bending or stretching) affect your ostomy appliance’s fit and make adjustments as necessary.

8. Avoid Creases and Folds

• Smooth Surface: Try to place the wafer on a smooth, flat surface of your abdomen. If there are creases or folds, consider using additional accessories like barrier rings or strips to level out the area. Some specialized ostomy appliances, such as the D-Ostomy, can help avoid problematic, non-smooth areas completely, eliminating their contribution to leaks.

9. Change the Appliance Regularly

• Routine Changes: Regularly changing your barrier (every 3 to 5 days, or as recommended) helps maintain a good fit and reduces the risk of leaks. Changing it more frequently if you notice wear or if the fit is compromised can also help.

10. Seek Professional Guidance

• Consult a WOC Nurse: A Wound, Ostomy, and Continence (WOC) nurse can assess your stoma and provide personalized advice on fitting your ostomy appliance. They can help with measuring, choosing the right products, and using accessories effectively.

The D-Ostomy system is created to allow room to avoid overlap of these incisions when an ostomy appliance is placed to minimize pain, leakage, and other complications that can result from an appliance overlapping a wound or scar. In the same way that the straight edge of the D-ostomy appliance can be used to avoid incisions and scars in the immediate post-operative phase, it can also be used to avoid scars, rolls, folds, other dressings, drains, second ostomies, bellybuttons and anything else that may be nearby to your ostomy long term.