This topic is about managing leakage and a peristomal wound for someone with a loop ileostomy. The person had been doing well for about a year until a small blemish turned into a painful, bleeding wound. Despite treatments like steroid injections and cauterization, the wound has grown and is causing significant issues with leakage, affecting daily life and healing. Here are some helpful tips and insights shared by others:

1. Ensure your skin is clean and completely dry before applying the pouch. Sometimes using fewer products can be more effective.

2. Try using a Coloplast large square barrier sheet or barrier extenders to create an extra seal and keep effluent away from the wound. Reaching out to Coloplast support staff might provide additional help.

3. Consider seeing a dermatologist for a new evaluation. Even if a culture is negative, conditions like pyoderma gangrenosum should still be considered.

4. A daily wound care routine that worked for someone else involved irrigating with Vashe wound solution, packing with silver alginate, and covering with tape. This helped close a large wound.

5. Applying a small piece of Micropore tape directly over the inflamed skin or wound before attaching the usual wafer can be effective. It's an inexpensive method that has worked for several people.

6. Hyperbaric oxygen therapy might speed up healing, as stoma wafers can limit oxygen delivery to the skin. Systemic oxygen could be beneficial.

7. Skin Tac adhesive wipes (in a white box with teal print) provided a stronger and longer-lasting seal for one user compared to Hollister Bravo adhesive wipes.

8. If issues continue, consider getting a second or additional opinion from a surgical or ostomy nurse. They can reassess the need for convexity, the choice of seal, and the overall appliance layering strategy.