Hypergranulation tissue is a common complication that occurs during the body’s natural wound healing process. It is characterized by an overgrowth of new tissue that rises above the surface of the surrounding skin. This excessive tissue formation can stall or impede the wound from closing properly. Managing this condition effectively is crucial for healing, and while some cases require professional intervention, many can be treated at home with the right knowledge.
What Hypergranulation Tissue Is
Normal granulation tissue is a necessary and healthy sign that a wound is progressing through the proliferative phase of healing. This healthy tissue typically appears pink or bright red, has a bumpy, cobblestone-like texture, and remains level with the surrounding skin. It is composed of new blood vessels and connective tissue. Hypergranulation tissue, however, represents an imbalance in this process, where the tissue growth becomes excessive.
This overgrowth typically appears as a raised mound that protrudes above the wound edges, preventing the outermost skin cells from migrating across the surface to close the wound. It is often dark red or purple, shiny, moist, and characteristically friable, meaning it bleeds easily. The primary reasons for this excessive growth are usually localized issues, such as prolonged inflammation or irritation.
Contributing factors to hypergranulation commonly include an excessive amount of moisture or exudate in the wound environment. When a wound remains too wet, it disrupts the balance of growth factors needed for orderly healing, stimulating the overproduction of tissue. Other causes include the presence of a localized infection, repeated friction, or irritation from a foreign body like a retained suture or poorly fitting dressing.
Safe and Effective Home Treatment Methods
The goal of home treatment for hypergranulation is to reduce the excessive tissue without causing further trauma, primarily by controlling moisture and applying gentle pressure. The most important step is to manage the wound’s moisture level, as excessive exudate is a major stimulant for overgrowth. This involves using highly absorbent, non-adherent dressings, such as foam or alginate dressings, which pull excess fluid away from the wound bed. Avoiding occlusive, non-breathable dressings is advised, as they can trap moisture and exacerbate the condition.
Wound Cleansing and Hygiene
Maintaining a clean and hygienic wound environment is fundamental to reducing the inflammation that drives overgrowth. Gently cleanse the area with a saline solution or mild, non-irritating wound cleanser during each dressing change. Harsh soaps, alcohol, or aggressive scrubbing should be avoided, as they can easily damage the delicate, friable tissue and increase irritation. Some professionals recommend using hypertonic saline dressings, which draw fluid out of the tissue by osmosis, to dry and flatten the overgrowth.
Applying Pressure
Applying gentle, consistent pressure to the raised tissue can physically help to flatten it and discourage further upward growth. This can be achieved by using a firm, non-restrictive bandaging technique or by incorporating a thin foam dressing directly over the hypergranulation. Specialized silicone sheets, which are available over the counter, are another method that can apply low-level compression while managing moisture and promoting a flatter scar profile. For wounds related to tubes or drains, ensuring the device is correctly secured and not causing excessive movement or friction is a direct way to remove the irritant cause.
Aggressive methods used by clinicians, such as chemical cautery with silver nitrate or surgical removal, are not safe for home use and should never be attempted. Silver nitrate is a caustic agent that requires precise application and risks chemical burns to the surrounding healthy skin if not handled by a trained professional. Home treatment must focus only on environmental management, gentle cleaning, and non-traumatic pressure application.
Signs That Require Professional Care
While home care is often effective, certain signs indicate that the condition is beyond self-management and requires professional care. The most serious red flags are signs of a spreading infection, which can be masked by the inflammation of the hypergranulation itself. Look for increased redness spreading outward from the wound, new or worsening pain, a foul odor, or thick, discolored discharge that may be green or yellow. A fever or general feeling of being unwell alongside these symptoms warrants urgent medical review.
Another clear sign to seek professional help is a lack of improvement or a worsening of the tissue after seven to ten days of consistent home treatment. If the hypergranulation continues to grow, or if it becomes extremely painful and bleeds profusely, it needs a professional assessment. A medical provider can apply stronger topical treatments, such as prescription topical steroids, or perform chemical cautery to reduce the overgrowth.
Any hypergranulation that appears hard to the touch, has a cauliflower-like appearance, or is growing aggressively outside the primary wound margin should be checked by a physician. These characteristics can sometimes mimic other, more serious conditions, and a professional diagnosis is necessary to rule out anything other than simple overgranulation. Wounds that are large, deep, or located over a joint are also better managed under the supervision of a wound care specialist, dermatologist, or primary care physician.