CLINICAL FINDINGS
Granulation tissue is the main finding in the unhealed skin grafts donor sites. This specialized tissue is typically observed in proliferative phase of wound healing. It usually grows from the wound bed and has the appearance of a red, moist, soft to touch tissue with a marked neo-angiogenesis6-7.
It’s aim is to fill the wound and prepare a vascularized and immunocompetent bed for deposition of collagen and epithelization.
An excess of granulation is defined hypergranulation or commonly “proud flesh” and it can be observed in wounds such post-surgical, pressure sores, burns ecc8.
This occurrence is due some factors such as prolonged inflammation, imbalance in matrix metalloproteinases, infections, mechanical friction, allergens, or early removal of dressings.
Due to subversion of the physiological skin architecture, hypergranulation prevents a correct migration and developments of epithelial cells.
In addition, the increased local production of fluids, cellular debris, and inflammatory tissues can promote an ideal environment for bacterial colonization that can further delay the wound closure.