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Come talk to me about overgranulation please!

(12 Posts)
pugsandseals Fri 11-Jan-13 12:05:38

Being dressed twice a week for a wound about the size of a 10p piece which was originally an infected cyst. For the 2nd time in a fortnight the nurse has found overgranulation on the same top edge of the wound & I'm thoroughly fed up with it sad. Just how much does overgranulation hold back the healing process & what can I expect next? Feeling very grateful the cyst was not cancerous, but how much longer? Been off since mid-November!

gallivantsaregood Fri 11-Jan-13 12:10:52

What does she do with the overgranulation? There is an eye ointment each works a treat on overgranulation around gastrostomy sites. Can't remember name but will come back to you

gallivantsaregood Fri 11-Jan-13 12:12:37

It is Maxitrol. Maybe ask your doc/nurse about it.

pugsandseals Fri 11-Jan-13 12:20:23

Not an eye wound though, this is on ribs under boob!

pugsandseals Fri 11-Jan-13 12:21:29

After a week of no longer packing the wound, she has today gone back to using Aquacel.

pugsandseals Fri 11-Jan-13 12:23:26

Have had silver, then honey & foam, then a jelly-type stuff (sorry don't know the name) before. Lots of blood today.

TheAccidentalExhibitionist Fri 11-Jan-13 12:32:01

Do you mean hypergranulation?

pugsandseals Fri 11-Jan-13 12:33:03

It's when the body forgets to stop making flesh & start making scar tissue/skin

TheAccidentalExhibitionist Fri 11-Jan-13 12:41:39

If its hypergranulation then there may be some irritant triggering it. By irritant I mean like a bra seam or pressure or even the edge of the dressing.
IME it can delay healing significantly. Not sure about this wound but in wounds I treat I often use Silver Nitrate to shrink it, but it will return if the irritant is still there.

TheAccidentalExhibitionist Fri 11-Jan-13 12:49:07

The ‘trigger point’ for this transformation is also unclear, but certain common background characteristics have been identified. Moist areas from exudates or bleeding which are also subject to prolonged physical irritation or friction with continued repetitive minor trauma or pressure appear to be particularly vulnerable; excessive inflammation, bacterial bioburden (critically colonised wounds), undercurrent infection, and a possible new scenario of negative pressure suction with microdeformation particularly applicable to large pore foam dressings constitute these background characteristics.5-8 Additionally it has been suggested that low oxygen levels and high moisture can stimulate granulation tissue formation and, for this reason, some companies advocate the use of occlusive dressings to encourage granulation tissue formation. The converse approach has therefore been used to treat hypergranulation – vapour permeable dressings (increased oxygen) with low moisture (absorbent dressing) to replace any occlusive dressing that may have been used.

Sorry for all the jargon here but basically it says: check for infection, remove pressure and friction, perhaps ask the nurse to change between occlusive and vapour permeable dressings to see which one responds best (once any infection has been treated)

gallivantsaregood Fri 11-Jan-13 13:16:56

I understand its not an eye problem. Neither is a gastrostomy. It's a stomach on the abdomen but Maxitrol eye ointment is used loads for over granukation of gastrostomy sites. Def worth a mention. I have USD it on my little boy who had terrible over granulated when he got his gastrostomy feeding tube......

pugsandseals Fri 11-Jan-13 14:08:31

Hmm, not sure which is worse, continue to wear the genie top I've been wearing & hope it's not too much pressure on the area, or go topless & risk boobs flopping around more & causing problems. Seems like neither is good! That eye stuff sounds good, I might mention that next week. Also anon-waterproof dressing. Thanks for the thoughts, just a shame it's as long a road as I feared it was!

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