Hypergranulation: exploring possible management options

Hypergranulation (or overgranulation) is an excess of granulation tissue beyond the amount required to replace the tissue deficit incurred as a result of skin injury or wounding. An infrequent but not rare consequence of wounding, the dearth of reliable evidence on the subject of hypergranulation has led to widely varying practices over time, including some which cause pain or discomfort and some which may further impair healing. However, despite a relatively poor evidence base, it is possible to ascertain that clinicians recognize different types of hypergranulation tissue in practice and that a variety of factors contribute to their development. Coupled with an understanding of normal healing processes, this differentiation of types and identification of contributory factors goes some way toward identifying effective treatment pathways and justifying treatment decisions, one of which includes adopting a wait and see approach.