Granulotion Review

This is the review I wrote for Granulotion, it was originally posted in October of 2014.

Does Granulotion get a thumbs up from me?  For short term use,  absolutely.

However, (and this is a big however) Granulotion is not the answer for long term management.  It does not fix what is causing the overgranulation, it only removes what is present at the time of application.

Any sort of astringent or caustic substance habitually applied to overgranulation tissue, serves to perpetuation the cycle of forming more overgranulation tissue.

Please take time to read the information provided under the Hypergranulation Tissue tab to understand better what overgranulation is, and why using any type of astringent or caustic substance to overgranulation is not a solution to stopping what is causing its formation, it removes it once it has formed.

Granulotion Review

Here are the photos showing how my hyper-granulation tissue responded to being treated with Granulotion.

If you’re just a casual reader of my blog, and have no real interest in granulation tissue, then probably skip the photos. They are not pretty!

Statistically, 60% of those with a tube will develop hyper-granulation tissue at one time or the other.  (In the interest of simplicity, I will refer to this as just “granulation tissue or gt ” throughout the rest of this post.)

I’ve stayed solidly within that 60% for all of the time I’ve had a tube.  Various things have made it better, but its never truly gone away until now; and, I think it is likely to come back unless I continue to maintain it with Granulotion.

Before I get started, let me preface my experience with how my skin has reacted to other forms of treatment, and what is typical for me in the past…

First, shortening the length, and thus reducing the weight of the tube dangling out of my stomach, back when I had the original “long tube” style, helped with discomfort, and may have reduced granulation some; however it did not go away.

Switching out the long tube for a low profile button type of feeding tube made a HUGE difference, but, again, the granulation tissue didn’t go away, it just was a lot better.

Applying steroid cream (triamcinolone acetonide cream)  would keep it almost (but not quite) gone. But, whenever I’d stop applying (less often  than once daily)  the granulation would come right back. And, between the known effects of long term use of steroids—skin thinning and rebound effect—it became clear that I had to find another way to manage it.

Silver nitrate sticks worked fast.  Using them, for me, was not particularly painful, but, I could never get it all, as I couldn’t reach what wasn’t visible at the surface,  and therefore gt always came back.  My son’s friend, who is a medical professional even helped with this once.  We removed the old tube, and he cauterized every bit of granulation tissue he could see inside of my stoma, but, it did not delay the return of the gt.

Alum (an additive used for making pickles) reduces granulation tissue for me, but its gritty, and not particularly pleasant or fast working.

A product called “Miracle Mist” also helped, but did not eliminate granulation tissue for me.

Enter “Granulotion”.  At first I wasn’t particularly impressed, as it definitely works slower than applying silver nitrate.  But the results?  Oh yes!  So completely worth the wait, and any discomfort along the way during the treatment process!

Keep in mind that these photos were taken really close up, so there’s lots of detail —making me regret  my nails weren’t polished! —and the treatment process is pretty gross looking.  None have been touched up. The next to last photo was taken in different lighting than the others. After almost a week, the chunk of granulation tissue finally fell off in the shower.

The morning of day two, for the fourth treatment I had some stinging. Nothing unbearable, certainly not as much as treating with silver nitrate. In fact, not really any worse than discomfort of the granulation tissue itself when it is bothering me.

Subsequent applications also stung, and I started to pay more attention to protecting skin outside of the area being treated.

According to the Granulotion website, it  uses micronized Potassium Alum to shrink Granulation tissue. Potassium Alum can cause stinging or mild burning if it comes in contact with severely irritated or excoriated skin. Use a separate skin barrier on any reddened/irritated skin creating a “bullseye” around the site, then pinpoint GranuLotion on the GT.

Below is a photo essay of my progression during the treatment process. All in all, I used the Granulotion for about six days. I tapered off how many times I applied it as the days went by.  Unfortunately, right at the end I developed a bit of a yeast infection at the stoma site, not due to the treatment, it probably was brewing from before I started the treatment. Because of this, once the granulation was finally gone, the area surrounding my stoma still shows signs of the yeast. The photos are “clickable” for slideshow.

before treatment

 

first treatment

before second treatment day one

before third treatment day one

before seventh treatment day 3

before 8th treatment

before 9th treatment day 3

before 10th treatment day 4

before 11th treatment

11th treatment

after treatment

 

 

 

Click the link below  to reach the Granulotion website: http://www.granulotion.com/

[UPDATE one week later]

I wanted to add one more photo, showing my finally granulation free stoma. The photo I supplied with the original post still showed signs of the fungal infection I was dealing with. It has cleared up (mostly) at this point.

My (finally!) granulation free stoma

My (finally!) granulation free stoma

For maintenance, I apply Granulotion once daily, a tiny dab at the top against the tube, and a dab at the bottom, against the tube, and then twirl the button a couple of times in each direction to work the Granulotion down into my stoma some.

As I’m not certain that the yeast is completely at bay, after the Granulotion, I then sprinkle the entire stoma area liberally with Coloplast Micro-Guard Antifungal Powder. Put a cloth pad on, and I’m done for the day.

 

[FOLLOW UP] I could not stick with using the Granulotion.  It did get rid of the GT, but it required daily application, which would not have been a problem except for the searing burning it caused to the surrounding skin near to my stoma.  I would think I had everything  adequately protected, but no matter what, it would make its way onto a raw spot, which in turn made that spot even rawer and more delicate.  The interesting thing is for me, at least, it did not cause pain to the actual target, it was the collateral damage that was the problem.  The more I would put off treating, the faster the granulation tissue would begin to show up.  I finally gave up, and went back to triamcinolone cream.

[UPDATE: Almost two years later]

I did not   continue with regular use, because of an inability to protect areas that weren’t in the treatment area, and I tired  of the  stinging from (I presume) the micronized alum in Granulotion.

In hindsight, I believe that that the real problem was that although Granulotion will get rid of any already formed granulation tissue,  it does not correct the cause of what is perpetuating the  granulation cycle.

In my case I feel the reason my stoma got  stuck in the healing cycle, and became a  stubborn chronic wound, was due mainly to friction, because of movement of my g-tube in my stoma.  A secondary cause, (also in hindsight) was the added irritation and inflammation from fungal infection.  Considering how moist this area constantly was, due to the drainage caused by the overgranulation;  yeast (fungus) existence is not at all surprising,

I also did not change my g tube  anywhere nearly as frequently as I should have.  Looking back, I remember that each time I did switch out the old button for a new one, for a while the granulation improved.

When I switched to a Corflo cuBBy button for a few months, that was when the granulation tissue slowly and steadily abated on its own accord.

The striking difference between the cuBBy and a Mic-key or Mini One is the little feet it sets up on.  Not only did this give the device stability, and greatly reduced friction from movement, but it also allowed air to get to my skin under the button, and air flow really cut down on making it a friendly host environment for yeast to flourish.

As a summary, written almost 24 months after the initial review, I would say, yes, Granulotion will get rid of granulation tissue.  But, yes, it will continue to need to be applied indefinitely unless the root cause for the granulation overgrowth is  discovered, and that cause is corrected.  And, if you are successful in adequately protecting the rest of the skin in the area from the Granulotion, it is a very good method to combat any hypergranulation tissue that is present.  Just understand, that until you address what is instigating its growth, the cycle will continue.