BAPEN. Malnutrition Universal Screening Tool (MUST). 2020. (accessed 22 February 2021)

Brown A. An overview of managing hypergranulation in wounds. Journal of Community Nursing. 2019; 33:(3)42-44

Dealey C. The care of wounds: a guide for nurses, 3rd edn. Oxford: Wiley-Blackwell; 2005

Falanga V. Occlusive wound dressings. Why, when, which?. Arch Dermatol. 1988; 124:(6)872-877

Goutos I, Ogawa R. Steroid tape: a promising adjunct to scar management. Scars Burn Heal. 2017; 3

Guest JF, Ayoub N, McIlwraith T Health economic burden that wounds impose on the National Health Service in the UK. BMJ Open. 2015; 5

Jaeger M, Harats M, Kornhaber R, Aviv U, Zerach A, Haik J. Treatment of hypergranulation tissue in burn wounds with topical steroid dressings: a case series. Int Med Case Rep J. 2016; 9:241-245

Johnson S. Haelan tape for the treatment of overgranulation tissue. Wounds UK. 2007; 3:(3)70-74

Joint Formulary Committee. British National Formulary (online.) Topical corticosteroids. 2021. (accessed 22 February 2021)

Lyman M. The remarkable life of the skin: an intimate journey across our surface.London: Bantam Press; 2019

McGrath A. Overcoming the challenge of overgranulation. Wounds UK. 2011; 7:(1)42-49

McShane DB, Bellet JS. Treatment of hypergranulation tissue with high potency topical corticosteroids in children. Pediatr Dermatol. 2012; 29:(5)675-678

Medlin S. Nutrition for wound healing. Br J Nurs. 2012; 21:S11-S15

Mitchell A. Wound assessment of acute and chronic wounds. Br J Nurs. 2020; 29:S18-S24

National Institute for Health and Care Excellence. Frequency of application of topical corticosteroids for a topical eczema. Technology appraisal guidance 81. 2004. (accessed 22 February 2021)

National Institute of Health and Care Excellence. Chronic wounds: advanced wound dressings and antimicrobial dressings. Evidence summary ESMPB2. 2016. (accessed 22 February 2021)

Oldfield A. The use of Haelan tape in the management of an overgranulated dehisced surgical wound. Wounds UK. 2009; 5:(2)80-81

Peate I, Stephens M. Wound care at a glance, 2nd edn. Hoboken (NJ): Wiley Blackwell; 2019

Stress: are we coping?. 2018. (accessed 22 February 2021)

Sundaramurthi D, Krishnan UM, Sethuraman S. Electrospun nanofibers as scaffolds for skin tissue engineering. Polymer Reviews (Phila Pa). 2014; 54:(2)348-376

van Luyn MJ, van Wachem PB, Nieuwenhuis P, Jonkman MF. Cytotoxicity testing of wound dressings using methylcellulose cell culture. Biomaterials. 1992; 13:(5)267-275

Vuolo J. Hypergranulation: exploring possible management options. Br J Nurs. 2010; 19:S4-S8

The assessment and management of hypergranulation

11 March 2021
Volume 30 · Issue 5


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.

Register now to continue reading

Thank you for visiting British Journal of Nursing and reading some of our peer-reviewed resources for nurses. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to clinical or professional articles

  • Unlimited access to the latest news, blogs and video content