Department of Dermatology, Stanford University, Redwood City, California.
Department of Dermatology, University of California, San Diego, San Diego, California.
Dermatol Surg. 2019 Dec;45(12):1507-1516. doi: 10.1097/DSS.0000000000002059.
Hypertrophic granulation tissue (HGT) is an uncommon but a frustrating complication of wound healing. Given its low prevalence and often refractory nature, many treatment options have been explored.
No comprehensive review exists on HGT management in dermatology literature; thus, the authors hope to compile a review of available treatments.
An exhaustive key word search of 3 databases was performed for treatment of HGT. Results from these reports were summarized in this review.
Methods of treatment included silver nitrate, topical steroids (n = 11), intralesional steroids (n = 55), steroid tape (n = 25), surgical removal, polyurethane foam dressing (n = 32), and pulsed-dye laser (n = 13).
With all treatment methods, the cases and studies reported varying degrees of successful treatment with HGT reduction. Given the lack of published literature, it remains unknown whether the initial injury preceding HGT formation determines treatment modality success. For HGT refractory to silver nitrate, choice of treatment depends on accessibility, ease of use, cost, and location of the wound. Intralesional and topical steroids should both be considered. Polyurethane foam can be considered an adjunct treatment. If resources allow, laser treatment should also be considered.
肥厚性肉芽组织（HGT）是一种罕见但令人沮丧的伤口愈合并发症。鉴于其低发生率和经常难治的性质，已经探索了许多治疗选择。
皮肤科文献中没有关于 HGT 治疗的综合综述；因此，作者希望编写一篇关于可用治疗方法的综述。
对 3 个数据库进行了全面的关键词搜索，以寻找治疗 HGT 的方法。本综述总结了这些报告的结果。
治疗方法包括硝酸银（n = 11）、局部类固醇（n = 55）、皮质内类固醇（n = 55）、类固醇贴（n = 25）、手术切除、聚氨酯泡沫敷料（n = 32）和脉冲染料激光（n = 13）。
对于所有治疗方法，报告的病例和研究都在不同程度上成功地减少了 HGT。鉴于发表的文献很少，目前尚不清楚导致 HGT 形成的初始损伤是否决定了治疗方式的成功。对于对硝酸银不敏感的 HGT，治疗选择取决于伤口的可及性、易用性、成本和位置。应考虑皮质内和局部类固醇。聚氨酯泡沫敷料可以作为辅助治疗。如果资源允许，也应考虑激光治疗。
