Open abdominal wounds with proximal active stomas present some of the most challenging and complex wounds, often exhibiting a deterioration in the integrity of the adjacent skin due to stoma leakage and associated repetitive laparotomy wound contamination. This can result in surgical site infection and tissue degeneration. In this article, the author aims to explore the challenges of managing patients with dehisced abdomens complicated by stoma leakage and adjacent skin fragility following radiotherapy.