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Treatment for hypergranulation at gastrostomy sites with sprinkling salt in paediatric patients
1Division of Surgery, National Centre for Child Health and Development, Tokyo, Japan.
Insights
Sprinkling salt treatment (SS) effectively reduced hypergranulation in paediatric gastrostomy sites. This inexpensive method, manageable at home, offers an alternative to traditional treatments like silver nitrate.
Area of Science:
- Pediatric Gastroenterology
- Wound Healing
- Dermatology
Background:
- Hypergranulation tissue commonly forms at gastrostomy sites in pediatric patients.
- Traditional treatments for hypergranulation, such as silver nitrate, can be costly and require professional administration.
Purpose of the Study:
- To evaluate the efficacy of sprinkling salt treatment (SS) for managing hypergranulation in pediatric gastrostomy sites.
- To determine if SS is a cost-effective and feasible home-care alternative.
Main Methods:
- A prospective case-series study involving pediatric patients with hypergranulation at gastrostomy sites.
- Daily application of a small amount of table salt to the hypergranulation tissue.
- Treatment continued at home by patients or caregivers until resolution, with monthly follow-ups.
Main Results:
- Hypergranulation decreased and flattened in all eight pediatric patients within 3 days to 2 months (median 7 days).
- Recurrences were successfully managed with repeated SS.
- Histopathological examination showed reduced interstitial edema in treated tissue; skin erosion occurred when treatment was prolonged, leading to protocol adjustment.
Conclusions:
- Sprinkling salt treatment induces a hypertonic environment that effectively reduces edematous hypergranulation tissue.
- SS is an inexpensive, parent-manageable, and repeatable treatment option for pediatric gastrostomy site hypergranulation.
- SS presents a viable alternative to traditional treatments like silver nitrate.
Objective:
To estimate the efficacy of sprinkling salt treatment (SS) of hypergranulation at gastrostomy sites in paediatric patients.
Method:
A prospective case-series study of paediatric patients with hypergranulation at gastrostomy sites. About one-third of a 5ml-teaspoon of table salt was sprinkled over the tissue once a day, either by the doctors/nurses in the wards or doctors in the outpatient setting. Treatment was continued by the patients or carers in the home, until the hypergranulation was seen to flatten. The patients were followed up by health professionals once a month.
Results:
Eight paediatric patients (seven females and one male) were included in the study. The hypergranulation decreased in size and became almost flat in all patients within 3 days to 2 months (median 7 days). Five patients had a recurrence of hypergranulation, but were treated successfully by repeated SS. Skin erosion was observed in one patient when SS was continued too long; therefore, the treatment protocol was altered so that the salt was irrigated 10 minutes after SS. A biopsy of the hypergranulation tissue was taken from a patient and salt was sprinkled on the tissue in a dish to simulate SS for histopathological examination. Histopathologically, hypergranulation treated by SS exhibited reduced interstitial oedema.
Conclusion:
The results of this study suggest that hypertonic environment induced by SS effectively reduced the oedematous hypergranulation tissue. SS is advantageous over traditional treatment such as silver nitrate in that SS is inexpensive and can be continued by the parents and repeated if necessary at home.
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