Abscess, Open Wound Under Flange

I'm just wondering if anyone can direct me to some good information on what to do about infection under the flange. I have had an open sore, oozing pus, about 1.5 cm from my stoma for about a week and a half. I went to the ET nurse and she gave me silver wound dressing and Duoderm, which I have changed twice since last Monday. Both times the wound was larger and there was more pus than the last time. The wound is now almost 1 cm across and a couple of mm deep, and I'm freaking out. I've had really good luck and not had significant skin problems in over 20 years of having a stoma. Any help or advice would be really appreciated!

Hey there,

I would recommend you contact your doctor.

Stay calm always, but I would also get a doctor to look at it at the hospital. I would want them to understand that your wound should be monitored and dressings changed regularly; maybe even a schedule of antibiotics is in order. You gotta advocate loudly for yourself, sometimes uncomfortably loud. Let us know about your recovery; be strong.

You probably need antibiotics. Wound care nurse needs to see this again. Don't let them ignore you. Pus is a sure sign of infection.

I had a 2.5 cm ulcer (1 cm deep) about 3 cm below my stoma and, with advice from a stoma nurse, I treated it with Aquacel Ag (silver dressings) - several layers packed into the ulcer and covered with Duoderm (and the base/bag over the top). I changed it every 4 days when I changed my bag - it took about 2 months to fully heal - but it did get a little larger (but with clearly defined edges) the first few times I changed the dressing then shrunk back down as it healed.

I hope you have access to a stoma nurse or if not, go see your doctor.

Stories of Living Life to the Fullest from Ostomy Advocates I Hollister

Ok, that's reassuring, thank you! I did go straight to the stoma nurse (ET is enterostomal therapy nurse) as soon as I noticed, and that's basically the same treatment as she's suggested. I am just worried because it seems to be getting worse, not better. I haven't been packing the wound, but I will see her again at the end of the week and ask her about that.

If not a fistula, is it? That happens. Ask about this. Serious stuff going on if there's an open wound. Agree with everyone above. Get it checked. Advise us. Keep us posted.

I don't think it's a fistula - there's no discharge except the pus, which is a pretty neutral color, and the skin around it seems healthy. I will definitely ask, though. Personally, I think it was just an infected follicle that got worse because it's in a moist, covered area - I'm prone to those in other areas as well, just never had one under my wafer before.

I hope you have seen that too by now. IGGIE

Definitely contact your doctor and follow up! One of the things my stoma nurse told me is that if you see an open wound, use stoma powder on the area and let it dry. I also use Domeboro powder dissolved in water when changing my bag. My sores are not as severe as what you have, but I will say that the Domeboro powder was a game changer for me and my belly.

Thanks everyone. I have another appointment with the stoma nurse on Friday. Did a change today and the wound opening was bigger but looked cleaner with less pus and discharge, less heat around the area. I moved the opening on my wafer over so the convexity isn't putting pressure right on top of the wound (saw this suggestion on an ET nurse training on YouTube - the internet is amazing!)

I will monitor and go in sooner if things get worse before Friday and let you all know how it goes.

I used Aquacel with Duoderm on top. Changed with each flange change (every 4 days for me). It took almost 6 weeks to heal completely. That was what my ostomy nurse sent me to use. But I agree, if you can see your nurse in person or send them a photo, you should seek a medical opinion.

Sounds the same as the advice I was given. I have seen the nurse in person twice now, and today she said it looked much better and just to keep doing what we were doing. She also gave me some pouches with a softer wafer and smaller convexity, but they are ridiculously big, so I'm not sure I'll be able to use them. Anyway, overall, feeling much more calm about everything. Thanks for all the support!