Hypergranulation tissue (HGT), often referred to as “proud flesh,” is a common complication where the body produces an excessive amount of granulation tissue. This tissue grows beyond the wound edges, creating a raised mound instead of remaining flush with the surrounding skin. This overgrowth significantly slows down the final stage of wound closure, known as epithelialization. Managing this overgrowth at home is important for restoring a healthy healing environment.
Identifying Hypergranulation Tissue and Its Causes
HGT presents with a distinct appearance, typically looking like a raised, beefy-red or pinkish mound that protrudes above the surrounding healthy skin. This tissue often has a shiny, moist surface and is highly friable, meaning it bleeds easily. Unlike normal granulation tissue, which remains level with the skin surface, HGT extends outward.
HGT is not an infection, but a response to a dysfunctional wound environment. Primary triggers include excessive moisture in the wound bed, often from heavy drainage or overly occlusive dressings. Constant friction or pressure, such as from ill-fitting dressings, clothing, or piercing jewelry, also stimulates the tissue to overproduce.
A bacterial imbalance or infection within the wound perpetuates the inflammatory phase, stimulating abnormal tissue growth. Identifying and eliminating the source of irritation is the necessary first step, as the hypergranulation will otherwise persist or recur.
Non-Invasive Methods for Reducing Overgrowth
The goal of home treatment is to reduce the size of the raised tissue by drawing out excess fluid and applying gentle, consistent pressure. Hypertonic saline soaks are an accessible and effective method to manage excess moisture. The high salt concentration uses osmosis to pull fluid out of the tissue, helping to dry and flatten the overgrowth.
To create a hypertonic soak, dissolve two teaspoons of common table salt in one cup of warm water; this is significantly saltier than standard saline solution. Soak clean gauze in the solution, then squeeze out the excess liquid so the gauze is moist but not dripping. Apply the gauze directly over the HGT for five to ten minutes, or until it cools.
Do not rinse the area afterward, allowing the salt to continue working. This process can be repeated up to four times per day, and noticeable improvement should be observed within seven to ten days of consistent application.
Another effective approach is the application of gentle, sustained compression to physically flatten the raised tissue. Use a non-silicone foam dressing, which is absorbent and less likely to stick. Cut the dressing to fit slightly larger than the HGT and secure it with tape, ensuring firm pressure is applied.
The constant pressure restricts the blood flow and cellular proliferation causing the overgrowth. The foam dressing also absorbs excess moisture or wound drainage. Change the dressing at least every other day to assess progress and ensure the compression remains effective.
Maintaining a Healthy Healing Environment
Once active overgrowth is addressed, focus must shift to optimizing the wound environment to prevent recurrence. Maintaining the correct moisture balance is crucial, ensuring the wound is neither too dry nor excessively wet. A wound that is too moist leads to maceration and provides an environment for HGT to develop.
Choosing the right secondary dressing, such as hydrocolloid or highly absorbent foam, helps manage exudate. If the HGT is near a device, like a feeding tube or piercing, apply a skin barrier to the surrounding healthy skin. Petroleum jelly or a specialized barrier cream protects the skin from irritation caused by moisture or device contact.
Minimizing foreign body irritation is also important. If HGT develops around a piercing, ensure the jewelry is made of a non-irritating material, like implant-grade titanium, and that the length is appropriate to prevent constant rubbing. Proper hygiene involves cleaning the area gently with a mild, non-cytotoxic cleanser at each dressing change.
Warning Signs and Seeking Professional Care
While home treatments are often successful, professional medical intervention may be necessary. If the hypergranulation tissue shows no sign of reduction after seven to ten days of consistent home care, consult a healthcare provider. A lack of response may indicate the underlying cause has not been addressed or that a stronger treatment, such as topical corticosteroids or silver nitrate, is required.
Certain signs require immediate attention, suggesting the issue is more serious than simple HGT. These red flags include increasing pain, warmth, or spreading redness, which can signal cellulitis. The presence of thick, discolored pus, a foul odor, or the development of a fever also indicate a significant infection.
Never attempt to physically cut, scrape, or forcefully remove the hypergranulation tissue at home. This can cause significant bleeding, introduce infection, and damage underlying healthy tissue. Harsh chemical agents or unrecommended home remedies should also be avoided, as they can cause severe tissue burns.