| G/GJ tubes: Hypergranulation tissue | 3019.00000000000 | G/GJ tubes: Hypergranulation tissue | G/GJ tubes: Hypergranulation tissue | G | English | Gastrointestinal;Other | Child (0-12 years);Teen (13-18 years) | Stomach;Abdomen;Small Intestine | Digestive system | Non-drug treatment | Adult (19+)
Caregivers | NA | | 2019-05-22T04:00:00Z | | Tharini Paramananthan, RN, BScN, MScN;Silvana Oppedisano, MN, RN(EC);Holly Norgrove, RN, BScN | | | | 6.70000000000000 | 67.4000000000000 | 648.000000000000 | | Health (A-Z) - Conditions | Health A-Z | <p>Learn what hypergranulation tissue is, why it forms and how to treat it if you notice it around your child's stoma.</p> | <p>Granulation tissue is the new tissue that forms when a wound is healing. It is also the extra tissue that grows around the feeding tube. Hypergranulation tissue is an excess of granulation tissue that is usually bumpy or swollen tissue that is shiny or wet, bleeds easily and can be painful. Hypergranulation tissue is the most common skin issue that occurs in children with <a href="/article?contentid=2536&language=English">G or GJ tubes</a>.<br></p> | <h2>How to keep a healthy stoma</h2>
<figure>
<span class="asset-image-title">Healthy stoma</span>
<img src="https://assets.aboutkidshealth.ca/AKHAssets/GTube_Stoma_HealthyStoma.jpg" alt="healthy stoma with feeding tube" /> </figure>
<p>To keep your child’s stoma healthy, you should:</p><ul><li>
<a href="/article?contentid=2536&language=English">Wash the stoma</a> daily with soap and water.</li><li>Allow the stoma to be open to the air.</li><li>Secure the tube well.</li><li>Avoid too much movement of the tube in the tract.</li><li>Address stoma leakage as soon as possible.</li><li>For a
<a href="/article?contentid=2908&language=English">low profile tube</a>.</li><ul><li>Make sure your child’s tube is a proper fit.</li><li>Check the volume of the tube’s balloon weekly.<br></li></ul></ul> | <h2>Key points</h2><ul><li>Granulation tissue is the new tissue that forms when a wound is healing, and it’s also the extra tissue that forms around the feeding tube; hypergranulation tissue is bumpy or swollen tissue that is wet and bleeds easily.</li><li>Hypergranulation tissue typically looks pink to dark red, it appears open, shiny or wet, appears puffy and can be painful.</li><li>Causes of hypergranulation tissue include too much movement of the feeding tube, the stoma is wet, too much pressure on the stoma, trauma to the stoma, or an infection.</li><li>To prevent hypergranulation tissue from forming, tape the feeding tube to the skin to prevent movement, make sure your child’s tube is the correct size, keep the stoma clean and dry, and prevent infections.</li><li>Hypergranulation tissue can be treated with hypertonic salt water soaks, hydrocortisone cream, antimicrobial foam dressing or silver nitrate.</li></ul> | | <h2>Signs of hypergranulation tissue</h2>
<figure><span class="asset-image-title">Hypergranulation tissue</span><img src="https://assets.aboutkidshealth.ca/AKHAssets/GTube_Stoma_GranulationTissue.jpg" alt="hypergranulation tissue around a G tube" /> </figure>
<p>Granulation tissue generally appears as follows. </p><ul><li>Usually pink to dark red tissue, but it does not spread like an infection</li><li>Can appear open, wet looking or shiny</li><li>Bleeds easily</li><li>Appears bubbly and puffy</li><li>Can be painful<br><br></li></ul> | <h2>Causes of hypergranulation tissue</h2><p>Hypergranulation tissue can form for several different reasons.</p><ul><li>The feeding tube moves in and out of stoma. This can happen when a
<a href="/article?contentid=2908&language=english">low-profile tube</a> is incorrectly sized</li><li>The stoma is wet. This coud be from excessive leaking or because the stoma is covered with a dressing, so it is not able to dry completely</li><li>There is too much pressure on the stoma. This may be because a low-profile tube is too tight, the tube has been accidentally pulled out or there was a recent tube change</li><li>There has been trauma to the stoma</li><li>Hypergranulation tissue may form when there is an
<a href="/article?contentid=2906&language=english">infection</a>. Hypergranulation tissue is
<strong>not</strong> the same as an infection</li><li>The stoma will usually look worse and hypergranulation tissue may form when a child is sick, for example with a respiratory illness or gastroenteritis, of if they are recovering from surgery</li></ul> | | | <h2>Treatment of hypergranulation tissue</h2><ul><li>Apply
<a href="/article?contentid=2907&language=english">hypertonic salt water soaks</a> up to four times a day.</li><li>Use hydrocortisone cream for a week to help with skin inflammation. Hydrocortisone 0.5% cream is available over the counter. You may be able to find hydrocortisone 1% cream over the counter but usually it is only available by prescription. Hydrocortisone is a short-term treatment so only use it for one week at time.</li><li>Use an antimicrobial foam dressing on the stoma. At SickKids, you can purchase AMD foam dressing from the Specialty Food Shop.</li><li>Use
<a href="/article?contentid=2909&language=english">silver nitrate</a> to burn away the extra tissue and promote healing. You will be taught in the clinic first and then you can continue to apply the silver nitrate at home. Do not apply hypertonic salt water soaks while using silver nitrate.</li><li>Silver dressings may also help manage hypergranulation tissue.</li></ul><p>Speak to your G tube specialist if the stoma does not improve or if the hypergranulation tissue gets worse.</p> | | | <h2>Prevention of hypergranulation tissue</h2><ul><li>Always secure the feeding tube well to avoid friction against the skin.</li><li>Make sure your child’s <a href="/article?contentid=2908&language=english">low profile balloon-type G tube</a> fits properly. If you think your child’s balloon-type G tube is too loose or too tight, contact your G tube team to re-measure the size of the tube. Check the volume of the water in the balloon weekly.</li>
<li>Do not put dressings on the stoma unless your medical team advises to do so.</li><li>Keep the stoma open and dry. Do not apply ointments or creams unless your health-care team advises you to do so.</li><li><a href="/article?contentid=3020&language=english">Manage leaking</a> around the tube.</li><li><a href="/article?contentid=2906&language=english">Prevent infection</a>.</li></ul> | | | | | | | | | | | | | | | | | <h2>At SickKids</h2><p>If your child is a SickKids patient, contact the G Tube Resource Nurse with any concerns.</p><h3>G Tube Resource Nurse contact info:</h3><p>Phone: 416-813-7177</p><p>Email: g.tubenurse@sickkids.ca</p> | | | | | | | | | | | G/GJ tubes: Hypergranulation tissue | | False | | | | | |
