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Liquid stool or moisture under the appliance is a critical factor that can lead to skin impairment in patients with an ostomy. When the ostomy appliance is not able to effectively manage moisture, it can create a conducive environment for skin irritation, maceration, and possibly infection. The skin around the stoma is delicate and can easily break down when exposed to moisture, which can lead to complications such as dermatitis and skin breakdown. Effective management of moisture is essential to maintain skin integrity and ensure the health and comfort of the patient.

While excessive movement of the appliance, improper dietary habits, and infrequent changing of the appliance can also contribute to issues related to ostomy care, they are not as directly linked to skin impairment as the presence of liquid stool or excess moisture. For example, if an appliance is secure and changed regularly, it can still function well even with some movement. Similarly, while dietary habits can impact stool consistency, they do not have as immediate an effect on the skin as moisture does. Frequent changing of the appliance is also a part of good ostomy care, reducing the chance of irritation and helping with skin health. Therefore, controlling moisture under the appliance is paramount in preventing skin impairment.