Wound Care Tutorial

Hypergranulation toe tissue with small sinus

Last Updated
19 May 2025

Quick Overview

Categories

Aim of Dressing

Apply pressure (not compression) to the hypergranulation tissue to reduce its growth and promote epithelisation

Associated Care Plans

Dressing Changes (Min - Max)

Twice Weekly

Shopping List

Small dressing pack

Dressing Pack (Small)

Normal saline

Non-sterile gloves

Wound Probe

Wound Probe

10ml Syringe

18g Cannula with inducer removed (used as a fine bore catheter)

Foam dressing

In this particular patient we used a hydrofiber as the the patient was bleeding from the area due to the high vascular tissue as well as patient being on anticoagulants.

UrgoStart (10cm x 10cm),Aquacel Ribbon (2cm x 45cm)

Biatain Non-Adhesive Foam Dressing

Biatain Foam (Non-adhesive) (10cm x 10cm)

Cotton Bandage and Crepe

Cotton Bandage and Crepe

Product Selection Disclaimer:

The wound care products being currently used are a suggestion ONLY. They do not take into account your patient's individual needs which you must assess. No funding from medical companies has been provided and wound care products are chosen on their merit and what is available on the NSW Health State Wound Care Contract. Where an exact brand name product is not available we suggest you review the alternative tab or use another wound care product from its category eg. Hydrofibre

Tutorial Steps

 Swipe 
Step 1

Clean the wound bed and the peri-wound very well. You will need to remove any old betadine that has built up since the last dressing change

Step 2

Probe the sinus and record this in your wound care chart and general nursing documentation.

Step 3

Very carefully retract the inducer from the 18G cannular and connect it to a 10ml syringe full of betadine.

Flush the sinus(s) multiple times. Also ‘milk’ or ‘express’ any puss or purulent fluid from around the wound by running your hand from the heel to the toes.

Clean the wound with betadine as well.

Step 4

Allow the betadine to dry. If you don’t it will be absorbed into the dressing and not into the wound bed.

Step 5

Using a wound care probe pack the sinus with the aquacel ribbon. In this case i had to cut the diameter of the aquacel down to allow it to fit the sinus. *Always make sure there is a piece of the dressing hanging out of the sinus to make removal easy.

Step 6

This is where you might use a foam dressing however for this patient we continued to use the aqaucel due to the atraumatic release of the dressing.

Step 7

Secure the dressing using a thing foam dressing, hypafix and cotton bandage and crepe to apply pressure to the hypergranulation area.

General Notes

What have we learnt:

1.Use a wound care probe to measure the depth of the sinus and to push in your preferred dressing product

2.You may want to do a biopsy to rule out other reasons for the tissue growth

3.Using a 18G cannula with the inducer removed and attach it to a 10ml syringe. This is great for flushing out the sinus with iodine or normal saline