What to do about red and raw ileostomy periskin?!

[ceebeeRN]

I am the treatment nurse on my unit on a pretty consistent basis and in the last two months, we have had 2 patients with ileostomies. We were ill equipped and only had the premeasured 1-piece colostomy bag available for the first patient, which were way too big for his stoma. Needless to say, the drainage got under the seal of the colostomy bags and there was a lot of leaking and not before long his skin became irritated. Our wound doctor ordered zinc oxide for around the stoma but that made it even worse because the adhesive would barely stick and the leaking and subsequent irritation was just as present as ever. Before long, that patient was transfered to another floor and I was never sure if the irritation issue was resolved. Now we have another patient with both an ileostomy and colostomy and it looks like its just as bad, if not worst than the 1st patient. The site is so red, that one MD saw it and suggested maybe we send him back to the hospital or at least follow up with the doctor who did the surgery to see what can be done about resolving the irritation. The colostomy site seems to be fine but once again its the ileostomy site that leaks through the skin barrier and his skin is now as raw and red looking as a lobster. we've tried multiple pouches and multiple skin barriers, including the presized 1 pieces and the 2 peices that need to be measured and cut to size. Nothing seems to be sticking...literally or figuratively! hence the leaking and further irritation. the rawer his skin gets, the less the skin barriers are adhering. the drainage from the stoma just breaks the seal of the skin barrier and the acidic drainage gets everywhere. To relieve a bit of the discomfort, the MD ordered mylanta to be applied to the irritation skin but once again, it doesn't really solve issue or provide a great amount of relief. I feel so bad for my patient!! any suggestions for what we should do to help?