Prevention of hypergranulation tissue after gastrostomy tube placement: A randomised controlled trial of hydrocolloid dressings

Int Wound J. 2019 Feb;16(1):41-46. doi: 10.1111/iwj.12978. Epub 2018 Aug 30.

Abstract

Hypergranulation tissue formation is a common complication after gastrostomy tube (G-tube) placement, occurring in 44%-68% of children. Hydrocolloid dressings are often used in the treatment of hypergranulation tissue but have not been studied for the prevention of postoperative hypergranulation tissue. An institutional review board (IRB)-approved, prospective, randomised study was performed in paediatric patients who underwent G-tube placement at a single, large children's hospital from January 2011 to November 2016. After placement, patients were randomly assigned to (1) standard postoperative G-tube care, (2) standard hydrocolloid G-tube dressing, or (3) silver-impregnated hydrocolloid G-tube dressing, and the incidences of postoperative hypergranulation tissue formation, tube dislodgement, infection, and emergency department use were compared. A total of 171 patients were enrolled; 128 patients (75%) had at least 4 months of follow up and were included in the analyses. Eighty-nine patients (69.5%) developed hypergranulation tissue during the postoperative period, with no significant differences in incidence among the three treatment arms. Of those who developed hypergranulation tissue, 46 (56%) visited the emergency department, compared with 6 of the 39 patients (19%) who did not develop hypergranulation tissue. Hydrocolloid dressings (standard or silver-impregnated) do not prevent the development of hypergranulation tissue or other complications after G-tube placement in paediatric patients.

Keywords: children; gastrostomy tube; hydrocolloid dressings; hypergranulation tissue.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Bandages, Hydrocolloid*
  • Child
  • Child, Preschool
  • Female
  • Gastrostomy / adverse effects*
  • Gastrostomy / methods*
  • Granulation Tissue / physiopathology*
  • Humans
  • Infant
  • Infant, Newborn
  • Intubation, Gastrointestinal / adverse effects*
  • Male
  • Postoperative Complications / etiology
  • Postoperative Complications / prevention & control*
  • Prospective Studies
  • Wound Healing / physiology*