507 Treatment of Hypertrophic Granulation in Burns: Review of the Literature

Linneman, Paul; Litt, Jeffrey

doi:10.1093/jbcr/iry006.429

Cited by 2 publications

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“…In a review of the literature, 12 only eight papers were found with data on wound closure rate for hypertrophic granulation wounds in humans, and these were small case series, not randomized or controlled trials. No papers documenting rate of wound closure with silver nitrate cautery were found.…”

Section: Discussionmentioning

confidence: 99%

Hypertrophic Granulation Wounds Treated With Silver Nitrate Sticks or With Topical Steroid: Rate of Wound Closure

Linneman

Litt

2021

Journal of Burn Care &Amp; Research

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Hypertrophic granulation (HG) is abnormal granulation tissue raised above the level of surrounding intact skin, and is thought to delay wound healing. Effective treatment to eliminate HG could speed healing, but this is not well studied. Two common treatments are chemical cautery with silver nitrate, and use of topical steroid. In a Midwestern burn and wound clinic, both of these treatments are employed. A quality improvement project compared wound size reduction for HG wounds undergoing the two treatment modalities. Retrospective chart review identified HG wounds treated during a one-year period, and compared wound size prior to and after one month of treatment (length, width and surface area). Results were presented to the clinic staff, and one year later the quality assurance project was repeated. The initial audit found data on 18 patients treated with silver nitrate cautery, and 16 patients treated with 1% hydrocortisone cream. Median length and width was decreased by 5 mm with silver nitrate cautery treatment, and by 14 mm with 1% hydrocortisone treatment (p<.05). The repeat audit one year later found 10 patients treated with silver nitrate, and 38 treated with hydrocortisone. Median length and width decreased by 0 and 2 mm respectively for silver nitrate cautery treatment, and 15 and 10 mm for 1% hydrocortisone treatment (p<.05). In conclusion, this uncontrolled review suggests faster healing in HG wounds treated with 1% hydrocortisone compared with those treated with silver nitrate cautery. Confirmation with controlled and randomized studies is warranted.

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Section: Discussionmentioning

confidence: 99%

Hypertrophic Granulation Wounds Treated With Silver Nitrate Sticks or With Topical Steroid: Rate of Wound Closure

Linneman

Litt

2021

Journal of Burn Care &Amp; Research

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“…All this to say that excessive granulation tissue inhibits epithelialization and delays healing [7]. To fight against this drift of the proliferation phase, healthcare teams use mechanical abrasion which is traumatic, or silver nitrate creams or corticosteroids [8,9]. This study aims to describe the in vivo effect of Prednicarbate on the hyper proliferation of granulation tissue in traumatic wounds and burns during directed scarring.…”

Section: Introductionmentioning

confidence: 99%

Effect of Prednicarbate On the Hyper Proliferation of the Granulation Tissue of Traumatic Wounds During Directed Healing: A Prospective Observational Study

2020

IJOR

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Background: The directed scarring of traumatic wounds in a surgical department often encounters drifts. During the proliferation phase, the granulation tissue can become excessive, blocking re-epithelialization and dooming a skin graft. To cope with this, healthcare teams often use topical corticosteroids such as Prednicarbate which is a nonhalogenated corticosteroid which does not pass into the systemic circulation. Purpose: The aim of this study is to describe the in vivo effect of Prednicarbate on the hyper proliferation of granulation tissue in trauma wounds and burns during directed scarring. Methods: A prospective observational study was carried out on patients admitted consecutively to the Orthopaedic and Trauma Surgery Department of Aristide le Dantec Hospital in Dakar. The application of 0.25% prednicarbate was twice daily on the hyperprofiltration areas of the wound bed of consenting patients. Demographic, clinical, therapeutic data and changes in granulation tissue were collected. Results: 12 patients participated with an average age 41.5 ± 18.94 years and a female to male sex ratio of 3/1. Domestic accidents were the most common wound occurrence in 7 cases. After at least 3 applications, the modifications observed were as follows: the proportion of hyper-budding surface was reduced by 3% on average. In 8 cases, the bed turned pink, with a texture changing from smooth to granite in 10 cases. A regression of the edema of the bed was observed in all the cases and the level of the bed of the wound which initially known epidermal, became epidermal in 10 cases. In 10 cases, the start of epidermal migration was observed from the skin edges. In 9 cases, or 75% of cases, it took just 1 tube to see a reduction in granulation tissue. Conclusion: Prednicarbate is a non-halogenated corticosteroid which is of interest in reducing the excessive proliferation of granulation tissue in traumatic wounds. By normalizing the level of granulation tissue, it promotes epidermal migration and the epithelialization phase.

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507 Treatment of Hypertrophic Granulation in Burns: Review of the Literature

Abstract: What modalities to treat HG are published? 2. How much does HG slow epithelialization? 3. How do treatment modalities compare in speeding healing? 4. What is the incidence of HG in burn care?

Cited by 2 publications

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Hypertrophic Granulation Wounds Treated With Silver Nitrate Sticks or With Topical Steroid: Rate of Wound Closure

Hypertrophic Granulation Wounds Treated With Silver Nitrate Sticks or With Topical Steroid: Rate of Wound Closure

Effect of Prednicarbate On the Hyper Proliferation of the Granulation Tissue of Traumatic Wounds During Directed Healing: A Prospective Observational Study

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