The skin barrier of the pouch must fit around the stoma without touching it. Some skin barriers have openings that you size and cut yourself. To start, gather these supplies: A measuring guide to help you find the right size opening for your stoma. Most pouches come with a guide, a pen or marker, curved scissors, a new pouch and a closure clip, if one is needed. Size your stoma using the measuring guide. Find the pouch opening that leaves about one eighth to one 16th of an inch all the way around the stoma. Keep in mind that stomas are not always round. Using the pen, mark the correct opening on the center of the skin barrier. Pull the back of the pouch away from the front. This will prevent you from cutting into the back of the pouch. Using the curved scissors, cut the opening. Remove the cut piece. Slowly, peel the backing off the barrier. Carefully place the barrier over the stoma. Press the barrier against the skin with your fingertips. Remove the outer ring of the backing if there is one. Lay your palm over the barrier and hold it there for 45 seconds to seal the barrier to your skin.
