Atrauman Ag can also be used when systemic antibiotic A hydroactive wound dressing that meets the require-
treatment becomes necessary for severe infections with ments of the granulation phase particularly well is the
markedly elevated C-reactive protein. It may be useful to transparent hydrogel dressing Hydrosorb. Its gel structure
carry out a microbial identification and antibiotic sensitiv- has a high water content, allowing it to deliver moisture
ity test to optimize the antibiotic therapy. independently to the wound over prolonged periods with-
out itself drying out. Especially when the formation of
Wound management in the granulation phase granulation tissue is stagnating, a therapy trial with the
If the wound floor is clean, granulation tissue can form hydroactive foam dressing PermaFoam may be useful. The
provided that the hemodynamic disorder underlying the specific mode of action of Hydrosorb is described from
ulcer continues to be compensated by compression page 55 onwards.
Hydrosorb reliably protects the
therapy.
developing granulation tissue
from drying out.
Peri-ulcer eczema
The nature of the granulation tissue is an important indi- Venous leg ulcer is frequently accompanied by eczema.
cator of the quality of the repair process. Granulation tis- The eczema may be due to colonization of the damaged
sue itself reacts with extreme sensitivity to exogenous skin with bacteria and fungi (microbial eczema) or may be
influences and interfering factors and should therefore be a contact allergy to topical medications.
treated as gently as possible. Fresh red granulation tissue
no longer requires to be cleaned and irrigated and needs The treatment is based on the general principles of
no ointments or powders to promote its growth. However, eczema therapy: The acute, weeping eczema is treated by
granulation tissue must be kept permanently moist with moist therapy, for example using moist tulle dressings
suitable hydroactive wound dressings. If the wound is with astringent or disinfectant solutions. The skin, howev-
allowed to become dry, cell necrosis again results in tis- er, should be prevented from drying out.
sue death. Granulation tissue also has to be protected
against mechanical irritation caused by stripping of cells Subacute or chronic eczema should be treated in a differ-
when changing the dressings. entiated manner, but using only non-allergic ointment
bases and substances. Zinc paste (Pasta zinci) and cold
This is because granulation tissue has an extremely adhe- cream (Unguentum leniens) in equal parts has proved a
sive quality because of the high-protein exudate and the successful therapy in such cases. Long-term therapy with
large number of superfine capillaries. Chronic ulcers fre- corticoid-containing topical preparations, however, should
quently show a constellation in which part of the wound be avoided due to the risk of skin atrophy.
is already granulated, while other parts are still in the
cleansing phase. If wound disinfection is required and
during mechanical debridement, the granulation tissue
should be spared.
Phase-specific wound management [40.41]
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