Indian Journal of Physical Medicine and Rehabilitation

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VOLUME 24 , ISSUE 1 ( March, 2013 ) > List of Articles

CASE REPORT

Management of Over-Granulation in a Diabetic Foot Ulcer: A Clinical Experience

I.N Krishnaprasad, V Soumya, S Abdulgafoor

Citation Information : Krishnaprasad I, Soumya V, Abdulgafoor S. Management of Over-Granulation in a Diabetic Foot Ulcer: A Clinical Experience. Indian J Phy Med Rehab 2013; 24 (1):19-22.

DOI: 10.5005/ijopmr-24-1-19

Published Online: 00-03-2013

Copyright Statement:  Copyright © 2013; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Over-granulation or exuberant granulation tissue is a common problem encountered in the care of chronic wounds, especially that of diabetic foot ulcers. There are several potential options for the treatment of this challenging problem. Some have an immediate short term effect but may have a longer term unfavourable effect, for example, silver nitrate application and surgical excision, which may delay wound healing by reverting the wound back to the inflammatory phase of healing. Other products, such as foams and silver dressings may offer some effect in short term, but their long term effects are questionable. The more recent research supports Haelan cream and tape as an efficacious and cost effective treatment for over-granulation in a variety of wound types. The future of treating over-granulation may lie with surgical lasers, since lasers can not only remove over-granulation tissue but will also cauterise small blood vessels and are very selective, leaving healing cells alone while removing excess and unhealthy tissue.

Recently Drs Lain and Carrington have demonstrated the utility of imiquimod, an immune-modulator with anti-angiogenic properties, in the treatment exuberant granulation tissue, in a patient with long standing diabetic foot ulcer, resistant to other forms of therapy. We adapted a modified version of their protocol in the management of a similar patient in our hospital and achieved a good result in lesser time than the former.


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