This is a case study regarding a 55-year old female who had been dealing with a problematic ileostomy for over six-months. She expressed concern that her appliance wear time was less than 12 hours and affected her activity level as well as her quality of life. This woman has had four bowel resections for Crohn's disease over the last 25 years resulting in two revised ileostomies with multiple abdominal scars, dimpling and an umbilical hernia creating alterations of her abdominal contour. She also had a 20-pound weight gain due to the onset of insulin-dependent diabetes mellitus from drug-induced pancreatitis. The location of her ileosotomy was slightly to the left of the abdominal midline within the hernia. She was constantly experiencing leaking of effluent resulting in peristomal denuded skin and yeast infections. She stated that her active life of gardening, swimming, fishing and traveling was being limited by her short ostomy appliance wear time. She saw the WOCN at an outpatient ostomy clinic to discuss these issues. For four-weeks, the focus of treatment was in managing her peristomal skin problems and improving her appliance wear time by using a skin barrier. The client became very interested in the different types of skin barriers available to ostomates and started a diary on her appliance wear times and her activity level while using a variety of different skin barriers with one or two-piece ostomy appliances, with and without soft convexity and with or without using an ostomy belt. She and the WOCN discussed her findings on a weekly basis. Over a month's time, she documented 14 different methods in using a skin barrier and found one to meet her needs. This collaboration resulted in positive outcomes for her in maintaining skin integrity, improving appliance wear time, and resuming an active lifestyle.