Download Overgranulation

Management Of Overgranulation
Treatment Options
Haelen Tape - Contains a moderately potent steroid
suitable for treating wounds with minimal exudate –
changed daily – patient can be shown to manage
dressing changes at home.
Foam - Dressings such as lyofoam Max.
Advice on application from Molnlycke
(The company who make Lyofoam) below:
• Layered foam to press/flatten
overgranulated tissue;
• Apply a cut piece of foam-foam side down
to wound bed shiny side up;
• Apply a slightly larger piece of cut foam and
place on top of the first piece;
• Secure firmly with an adhesive dressing;
• Can be used under compression; bandages
or hosiery.
• For further information or guidance contact
your local Tissue
viability service.
Signs of Overgranulated Tissue
•
•
•
•
Proud granulating tissue;
May bleed easily;
Exudate levels may be high or low;
Recognised as red or purple in colour,
friable, often shiny and soft in appearance
that protrudes above the surrounding skin.
Antimicrobial - Can be applied under a foam
dressing if infection present.
Steroid Cream- should not be first line treatment.
As the majority of steroids are not licensed to treat
overgranulation, Steroid treatment can be effective
in reducing the inflammatory response (NICE,
2004). It is advised to start with a mild steroid and
increase potency if no response following 2 weeks
of application.
Always follow application advice from GP or from
manufacturer’s instructions.
What is Overgranulation?
Other points to consider
Overgranulation - Also described as
Hypergranulation or proud flesh.
Defined as an excess of granulating tissue beyond
the amount required to replace the tissue deficit of a
wound (Voulo 2010) Wound Essentials Vol 9, 2014
It is thought to be caused an altered inflammatory
response.
Overgranulation has a high risk of infection due to
the cells not moving vertically which can delay
healing (EWMA, 2006)
•
•
•
•
•
Discuss treatment options with patient;
Swab wound if infection suspected;
Consider malignancy if no improvement;
Malignancy can sometimes resemble
overgranulation tissue;
Refer to dermatology for a biopsy if in doubt!
Further reading-Wound Essentials;Vol-9 2014
What can cause Overgranulation?
•
•
•
•
•
Foreign Body-irritant in wound bed (e.g.
suture post op or dressing fibres);
Infection in wound;
Friction usually related to tubing such as
catheters, and peg sites;
Poorly managed exudate;
Occlusive dressings such as hydrocolloids.
Tissue Viability Team
April 2015