title: Treatment for hypergranulation at gastrostomy sites with sprinkling salt in paediatric patients.
abstract: OBJECTIVE
  To estimate the efficacy of sprinkling salt treatment (SS) of hypergranulation at gastrostomy sites in paediatric patients.
  
  
  METHODS
  A prospective case-series study of paediatric patients with hypergranulation at gastrostomy sites. About one-third of a 5ml-teaspoon of table salt was sprinkled over the tissue once a day, either by the doctors/nurses in the wards or doctors in the outpatient setting. Treatment was continued by the patients or carers in the home, until the hypergranulation was seen to flatten. The patients were followed up by health professionals once a month.
  
  
  RESULTS
  Eight paediatric patients (seven females and one male) were included in the study. The hypergranulation decreased in size and became almost flat in all patients within 3 days to 2 months (median 7 days). Five patients had a recurrence of hypergranulation, but were treated successfully by repeated SS. Skin erosion was observed in one patient when SS was continued too long; therefore, the treatment protocol was altered so that the salt was irrigated 10 minutes after SS. A biopsy of the hypergranulation tissue was taken from a patient and salt was sprinkled on the tissue in a dish to simulate SS for histopathological examination. Histopathologically, hypergranulation treated by SS exhibited reduced interstitial oedema.
  
  
  CONCLUSIONS
  The results of this study suggest that hypertonic environment induced by SS effectively reduced the oedematous hypergranulation tissue. SS is advantageous over traditional treatment such as silver nitrate in that SS is inexpensive and can be continued by the parents and repeated if necessary at home.
authors.affiliation: Division of Surgery, National Centre for Child Health and Development, Tokyo, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Tanaka
authors.forename: K
authors.initials: K
authors.lastname: Arai
authors.forename: A
authors.initials: A
authors.lastname: Fujino
authors.forename: N
authors.initials: N
authors.lastname: Takeda
authors.forename: T
authors.initials: T
authors.lastname: Watanabe
authors.forename: Y
authors.initials: Y
authors.lastname: Fuchimoto
authors.forename: Y
authors.initials: Y
authors.lastname: Kanamori
mesh_terms: D000287:Administration, Topical; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003240:Connective Tissue Diseases / Q000209:etiology / Q000628:therapy*; D005260:Female; D005774:Gastrostomy / Q000009:adverse effects*; D006097:Granulation Tissue; D006801:Humans; D007223:Infant; D008297:Male; D011446:Prospective Studies; D012008:Recurrence; D017673:Sodium Chloride, Dietary / Q000008:administration & dosage* / Q000009:adverse effects; D014945:Wound Healing
chemical_list: D017673:Sodium Chloride, Dietary