This topic is about managing a complex wound situation around a stoma, where a mother in a long-term acute-care facility is dealing with a deep peristomal wound and issues with a wound-vac leakage. Here are some insights and advice to help manage this situation:

- The wound-care staff are currently using a lot of ostomy paste to fill the cavity beside the stoma and placing the wound-vac sponge next to it. However, they are having trouble maintaining a good seal, leading to stool and gas leaking into the wound and under the barrier flange.

- The repeated removal of tape without using adhesive remover is damaging the skin around the stoma. Additionally, the wafer opening is being cut without proper measurement, resulting in an uneven hole that encroaches on the stoma.

- The surrounding skin is breaking down, and some tissue is still necrotic, requiring debridement. The daughter is concerned about managing this care herself once her mother is discharged and is looking for practical solutions to separate the wound and stoma management.

- She plans to order samples of better products to leave in the room, as the current supplies are not effective. She also intends to start emptying and charting the pouch output herself, as the staff often let it overfill with gas.

- Before discharge, she wants to learn the correct techniques for managing her mother's care at home without causing friction with the staff.

Here are some practical suggestions:

1. Consider asking Salts Healthcare for samples of Dermacol Stoma Collars. These collars come in various sizes, so it's important to measure the stoma first. By customizing two collars, one can encircle the stoma and the other can surround the wound, creating separate protective zones that adjoin each other.

2. Explore online education and support through the ME+ programme, which is advertised on the site. It might be helpful to report back on its usefulness.