Certified Wound Ostomy Nurse (CWON) Practice Test

What is the recommended treatment for hypertrophic granulation tissue associated with a percutaneous tube?

1. Apply a high-potency steroid cream

2. Stabilize the tube and treat with AgNO3 or mid-potency steroid

3. Use only polyurethane foam dressings

4. Remove the tube and apply antibiotics

The correct answer is: Stabilize the tube and treat with AgNO3 or mid-potency steroid

The recommended treatment for hypertrophic granulation tissue associated with a percutaneous tube involves stabilizing the tube and applying treatments such as silver nitrate (AgNO3) or mid-potency steroid. This approach is effective because hypertrophic granulation tissue can result from irritation and inflammation at the site of the tube placement. By stabilizing the tube, you reduce ongoing mechanical irritation, allowing the tissue to heal more effectively. Silver nitrate is used due to its ability to cauterize and thus reduce excessive tissue growth, helping to minimize the size of the granulation tissue. Mid-potency steroid medications can help reduce inflammation and relieve irritation, further addressing the underlying issue. In contrast, using high-potency steroid creams might not be appropriate as they could thin the surrounding skin and may not adequately address the granulation tissue itself. Similarly, relying solely on polyurethane foam dressings would not address the underlying cause of irritation or inflammation linked to the tube. Removing the tube and applying antibiotics may not always be necessary or effective in treating hypertrophic granulation tissue, as the focus should be on managing the tissue changes rather than removing the tube unless there are signs of infection.