The assessment and management of hypergranulation
Wound healing follows a process of four distinct phases: haemostasis, inflammation, proliferation and maturation. Problems can arise in any of these phases, delaying the wound process. Hypergranulation (also known as overgranulation) during the proliferation phase occurs when granulation tissue over grows beyond the wound surface. Such wounds have a discoloured, raised or swollen appearance and bleed easily. The cause may be infection, the effects of friction on the wound area, nutritional deficit or stress. Treatments will depend on the cause. There is a lack of studies on treatments for hypergranulaton and more research is required.
The maintenance and protection of skin and its integrity is one of the major components of nursing care. Yet, wound care in clinical practice continues to be considered a high-cost, complex, inconsistent activity. The treatment and management of wounds is a specialism and requires nurses to attend regular updates and training (Guest et al, 2015).
The wound-healing process follows four distinct phases. These are:
Barriers to wound healing often occur in one of these four stages, consequently delaying the healing process (Mitchell, 2020). Hypergranulation, also called overgranulation, is a common issue in wounds and often inhibits healing. The number of hypergranulation cases in wounds is relatively unknown and limited knowledge of the problem among health professionals can lead to underdiagnosis (Vuolo, 2010). Additionally, the absence of best practice guidance for managing hypergranulation can lead to a disparity in treatment and nursing practice.
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