What is the best nonsurgical treatment for granulation tissues along a sternotomy wound?
Are you referring to the wound edges of the wound? OR promoting granulation tissue within the wound. Two different approaches.
Dr Thimsen, I mean granulation tissues within the wound several weeks post surgery.
Dr Scalise, the problem of negative pressure is that it requires admission to hospital
In the US we have patients discharged home with negative pressure. It is critical that family are trained and educated in applying the dressing and emptying the cannister. In addition, having a nurse visit for the 3 times per week dressing changes is also part of the plan.
If electricity is not available, we pack the wound with a moist wound dressing and change it daily. A wet or damp to dry dressing is not used as it will delay the granulation process.
A typical dressing might be: a hydrogel impregnated dressing, impreganted gauze, moistened alginate. Change once/day.
If there are problem of negative pressure management we use moist dressing or hyaluronic acid dressing that work well when there no a deep wound
One can use negative pressure wound management as in or out patient. In case of superficial wound where the granulation tissue prevents or prolongs the epithelial coverage of the granulation, one can apply neomysin-cortison or genatamysin-hydrocortison salve/cream for 6 weeks on the granulation tissue before dressing. This way hydrocortison prevents granulation growth over skin edge and helping the epithelialisation. Genatamycin/neomysin salve/cream prevents infection.
Best regards,
Khalil Ahmad, Aarhus University Hospital
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