The wound has been slowly healing since surgery five weeks ago but within the past week has been overgranulating quite quickly. This can cause issues, particularly with delaying the healing of the wound.
Over What Now?
Overgranulation, aka hypergranulation, aka exuberant granulation tissue, aka proud flesh, is an excess of granulation tissue that rises above the surface in the wound bed and therefore hinders healing.
Wound healing is a complex business and as such my knowledge is somewhat limited. Granulation is the process where new tissue is constructed and part of this process is through dermal fibroblasts. Dermal fibroblasts are cells within the dermis layer of skin which are responsible for generating connective tissue and allowing the skin to recover from injury.
During the healing process, cells move from the edges across but where over granulation occurs, the cells are hindered from moving across the wound bed and the wound healing process can stop. So instead of moving across the wound, the tissue is halted at the edge of the swelling.
At least that’s my understanding of the overgranulation and how it affects the wound healing process.
When a photograph of the wound was taken on October 18th, there was only a small amount of overgranulation and on October 24th, a practice nurse did comment on it but no action was taken.
Wound on October 18th
The district nurse who last saw me straight after the VAC dressing was removed hadn’t seen the wound in a couple of weeks so was surprised by the amount of overgranulation and asked if any hydrocortisone cream was being applied to it – it wasn’t. The wound was healthy looking and in her words, looking ‘quite beefy’!
Wound on October 26th
Based on her concerns an updated photograph was taken which has been sent to my surgical care practitioner for her opinion. It’s useful having her as a contact and she’s taken a keen interest in ensuring my wound is healed so is happy for me to send random photos of the wound.
Using is hydrocortisone cream is one recommendation but there are other treatment options including silver nitrate sticks but some treatments do come with disadvantages so waiting to see what she recommends.