This topic is about dealing with a small granuloma at the junction where the stoma meets the skin. This can be a bit tricky because it tends to bleed and get irritated, especially where the skin barrier rubs against it. The person dealing with this issue is looking for advice on treatment options, particularly about using silver nitrate, and is unsure which healthcare professional should be responsible for this care. Here are some helpful insights and advice:

1. Finding Qualified Help
- Reach out to the Wound-Care Department at local hospitals. Ostomy nurses are often part of this team and might offer outpatient visits.
- You can also contact ostomy nurses from companies like Hollister, Convatec, Coloplast, and Nu-Hope Labs. They provide free consultations over the phone.

2. Silver Nitrate Self-Treatment
- You can buy 75% silver-nitrate sticks without a prescription, either individually or in bulk from places like Amazon.
- To apply, dry the area and gently press the stick against the granuloma for about 10 seconds. It might sting or burn a bit.
- Typically, you should apply it 1–2 times a week until the granuloma shrinks. Some people have seen results after just a few treatments.
- It's best to do this during your regular appliance changes, but be careful not to overuse it to avoid deep burns.

3. When Self-Care Is Not Enough
- If the granuloma doesn't improve after several treatments or has grown over time, it's a good idea to see a surgeon, dermatologist, or an experienced ostomy nurse. They might suggest minor surgical removal or cauterization.

4. Troubleshooting
- Make sure the hole in the wafer is the right size. If it's too tight or too loose, it can cause friction that might worsen or maintain the granuloma.