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The presence of hypergranulation tissue will delay the onset of epithelialisation. There are several methods to control hypergranualtion. Application of a foam dressing such as Allevyn (cut to size) taped with moderate pressure will dehydrate the hypergranulated tissue as well as providing direct pressure. I have had a lot of success with hydrocortisone cream 1% under a foam, applied daily until resolved. Silver nitrate solution or sticks also work but, I believe can be painful and should only be used by experienced practitioners. These treatments are cited in The Wound Care Manual by K. Carville.
Hope this helps
Karen CNS

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Shelia-
My personal favorite treatment for hypergranulated wounds varies according to the amount of drainage...scant drainage clean, dry, non-adhesive change qd; min. to mod. drainage Polymem q3 days works great; however for heavier draining wounds a simple petroleum based (Xeroform) covered with gauze works well. I have seen plastic surgeons use silvernitrate sticks to decrease the granulation then cover with petroleum based dressing change qod.
Tina (LVN, treatment nurse)

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Foam Dressings are the best for hypergranulation...Polymen, Biatain, Smith & Nephew's Allevyn Hydrocellular to mention a few.
Good Luck,
Cecelia LPN, WCC
Chicago, Illinois

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Hi Sheila,

I work as a Physical Therapist in a Nursing Home setting. I treat a lot of decubitus ulcers and had come across hypergranulating wound. My PTA and I had great success in slowing down the rate of hypergranulation or just totally flattening out the wound bed which is devoid of necrotic tissue. I have used providone iodine sparingly brushed or patted on the hypergranulating wound bed and covered with dry 4 x 4 gauze secured firmly with tape or applicable cover.Dressing change done qd or as indicated by location or amount of drainage or contamination. Works wonders. Hope this helps.

Neil Claveria LPT
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We have always used Polymem foam to hypergranulating wounds at the wound center. C. Adams LPN WCC HBOT

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regarding hypergranulation. I have used a 1per cent cortisone cream applied
to wound second daily very effectively.

Cheers, Eileen Oosthuis

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hypergranulating wounds
1. get rid of the hypergranulation by
     a. snipping it off with a scissor
     b. scraping it off with the handle of a BP blade holder
     c. chemically with CuSO4 crystals or silver nitrate
2. use a pressure dressing where possible to prevent the hypergranulation from re-appearing

unsigned

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Lee,
Maggot therapy is only good when you have wound that has dead tissue or infection. Xenaderm is recommended for treating of decubitus ulcers, varicose ulcers and dehiscent wounds. It promotes healing, acts as a moisture barrier, improves epithelialization and can aid in reducing pain in the wound area, You can use it twice daily. But if you are considering trying this type of dressing you need to consult your wound care physician and discuss this option with them. Good Luck,.....Jan, LPN Wound Care Director

Hi Sandra,

I recently used to work in a Long Term Acute Care facility. Over a year ago, our Pharmacy Director also attempted to use cheaper papain urea products, which Kovia and Ziox were our substitutes. All four of our campuses began using those products and after a few months, we all began complaining, as the wounds were declining and the ones that improved did so at a very slow pace. I belong to a Four Campus Wound Care Committee, and our Director, who is an Infectious Disease doctor, requested I do a case study for him to present at the Pharmaceutical Directors meeting.

I did a 20 patient study with 10 patient's receiving Accuzyme and 10 patients receving Kovia. The patients all had extremely close medical history's and wounds of the same etiology. Of course, Accuzyme blew Kovia out of the race...it was no comparsion, as Accuzyme proved to be much better with removing the necrotic tissue faster, and at a cheaper cost to the patient and organization, as compared to the Kovia.

I also did a 10 patient study with 5 patient's receiving Panafil and 5 patients receiving Ziox. Again, Panafil proved to be the better product.

My Case Study was presented and we always used Accuzyme and Panafil after that...and to the best of my knowledge, the organization still continues to use them.

One thing you must remember in your practice...wound care products are guidelines and each patient and each wound must be treated individually...meaning one product may work great on one patient and not so great on another.

Good Luck,
Cecelia LPN WCC
Chicago, Illinois

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We have had numerous problems with Kovia and Ziox at our wound center. I am talking about it separating. Part of it liquidy and the other part ointment. It wasn't any good. We do not use it now and put DAW on the orders. I would stick with the Panafil and Accuzyme from Healthpoint. C. Adams LPN WCC HBOT

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Our facility changed to Wound Wash Saline after studying the options.
Bottles of saline were much more expensive and saline without a preservative should be discarded after 24 hours. It comes in a spray can and shoots a
stream suitable for irrigating wounds.The company will send samples if
requested.

Sharon

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A number of vendors have replied to this question. We usually do not post messages that appear to be advertisements, but since Martha specifically asked for sources to obtain the product, we will list their URL's below:

www.mar-jmedical.com (Jason Housenbold)
www.mooremedical.com
www.medexusa.com  (Robert Perez, VP)

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Note: This type of question is best answered by the manufacturer.