Management of granulation tissue
Granulation tissue is new connective tissue with a combination of small blood vessels and fibroblasts. It is formed during the process of wound healing by secondary intention.
What is hypergranulation tissue?
Hypergranulation tissue is spongy, friable, and deep-red colored. Hypergranulation tissue usually occurs due to excessive inflammation. This is especially true for deep dermal burns and full thickness burns that are not treated with skin grafts and may become subject to stimuli causing excessive inflammation, such as infection, dermatitis, occlusive dressings, use of SSD for longer than 1 week, friction from external devices or foreign bodies.
Treatment of hypergranulation tissue
Treat small areas of hypergranulation tissue with topical agents that reduce moisture. For example:
- Zinc oxide ointment
- Silver nitrate stick (apply Vaseline to the healthy skin surrounding the burn to protect it)
- Oxytetracycline hydrochloride and hydrocortisone acetate (Terra-Cotril®)
- Papaya
- Topical Steroid, Class III or V
Larger areas of hypergranulation tissue may require surgical excision. Excision of these larger areas of hypergranulation should be followed by skin grafting to cover the wound