This topic is about dealing with an infected open wound, or abscess, that has developed under the ostomy flange. The person sharing their experience has had a stoma for over 20 years without major skin issues until now. They discovered a sore near the stoma that has been oozing pus and growing in size. Despite using silver wound dressings and Duoderm, the wound continued to worsen, causing significant worry. Here are some pieces of advice and insights shared by others:

1. Seek prompt medical evaluation:
- It's important to have a doctor or hospital review the situation immediately, as systemic antibiotics might be necessary.
- Ensure follow-up care from a wound or ostomy nurse, as pus indicates an active infection that needs close monitoring.

2. Dressing protocol that worked for others:
- Consider packing the ulcer with multiple layers of Aquacel Ag, a silver-impregnated fiber dressing, covering it with Duoderm, and then applying the flange/pouch.
- Change the entire system every 3–4 days. The ulcer may initially enlarge but should start to contract and heal over 6–8 weeks.

3. Supplementary topical care:
- Dust open areas with ostomy or stoma powder and let it dry before applying the wafer.
- Rinse the peristomal skin with Domeboro solution at each appliance change, which has been described as a "game-changer" for recurrent sores.

4. Appliance adjustments to reduce trauma:
- Temporarily adjust the wafer opening so that the convexity pressure is moved away from the wound.
- If possible, try pouches with a softer wafer or shallower convexity to reduce pressure on the healing tissue.

5. Differential considerations:
- Ask the nurse or doctor to rule out a fistula or other deeper complications whenever there is an unexplained draining wound near the stoma.

6. General reminders:
- Keep dressings and wafer changes on a regular schedule.
- Document changes in the wound's size, color, and amount of exudate, and take photographs to share with healthcare providers.
- Advocate strongly for yourself if symptoms worsen or if healthcare providers are slow to respond.