Treatment of hypergranulation tissue in burn wounds with topical steroid dressings: a case series

Abstract

Hypergranulation tissue (or also known as overgranulation) may negatively influence burn wound healing time and contribute to recurrence of contractures in burn wounds and grafts. Subsequently, the treatment of hypergranulation tissue remains controversial and problematic. In this case series, we aimed to examine the feasibility and document the use of topical hydrocortisone in the treatment of hypergranulation tissue formation resulting from burn wounds. We report five cases where hypergranulation tissue developed following deep dermal/full-thickness burns. Initial burn wound treatment included necrotic tissue debridement, wound cleansing, and Flaminal®. All five cases underwent surgical debridement and split-skin grafting. Upon identification of hypergranulation tissue, hydrocortisone acetate 0.25% was applied topically as usual care for the treatment of hypergranulation tissue. All five patients had deep dermal/full-thickness burns with a total body surface area ranging from 22% to 61% and were aged from 3–41 years. All five cases developed hypergranulation tissue during their admission after debridement and split-thickness skin grafts. All patients showed an improvement in the treated areas with a complete regression of hypergranulation tissue and closure of the burn wounds. No clinically apparent local or systemic side effects of the treatment were observed. Topical hydrocortisone can be utilized as an effective, inexpensive, and noninvasive practical option in the treatment of hypergranulation tissue resulting from burn wounds.

Anti-Aging β-Klotho Gene-Activated Scaffold Promotes Rejuvenative Wound Healing Response in Human Adipose-Derived Stem Cells

“…Angiogenesis is also a crucial event for granulation tissue development and its activity diminishes as the granulation tissue mature [47]. This programmed limitation of the angiogenic activity at the healing's later stages is essential for controlling scarring and hypergranulation that can impede re-epithelialization [48]. Our finding also shows that the ADSCs on the gene-activated scaffold can enhance endothelial sprouting and control their growth through paracrine signaling.…”

Proposed quality performance indicators of sentinel lymph node biopsy for cutaneous melanoma

“…Graft failure: Unsuccessful adherence of the graft to the wound site and/or failure of revascularisation 18 Hypergranulation: Excess of granulation tissue filling the wound bed than what is required for normal healing 19 Wound dehiscence: Rupturing/separation of the margins of wound closure 20 …”

Wound healing: potential therapeutic options

“…However, given that excessive inflammation can delay healing, topical steroids are sometimes used for wounds with excessive granulation tissue. 84,85 It is used as primary treatment for certain wounds such as pyoderma gangrenosum, which is driven by an underlying inflammatory condition.…”

“…Other medications that reduce inflammation (nonsteroidal anti‐inflammatory drugs, chemotherapeutic agents, immunosuppressants) also slow healing. However, given that excessive inflammation can delay healing, topical steroids are sometimes used for wounds with excessive granulation tissue 84,85 . It is used as primary treatment for certain wounds such as pyoderma gangrenosum, which is driven by an underlying inflammatory condition.…”