Ileostomy care advice

  1. I am new in the this field. I'm hoping someone has a good tx idea for me. The patient developed a fistula near their stoma which constantly pours gastric acid onto the the ostomy site, eating through the wafer. The hospital tried a colostomy bag over fistula site before but it wouldn't stick and the site was difficult to fit well and fistula opening started eroding. The abd/flank area skin is so raw it's nonexistent. The only place it is semi-decent is directly around the ostomy. Here's what we've been doing: We clean the skin and use skin prep and adapt paste to apply wafer and we use urostomy bags. For the rest of the abd/flank we clean with NS, apply nystatin and then #3 sensicare over that (we do not wash it off). We fluff kling or gauze over the sensicare to wick drainage, then ABD pads.