Granulation Tissue

Definition

Granulation tissue is new connective tissue and microscopic blood vessels that form on the surface of a wound during the proliferative phase of healing. It appears as beefy, red, bumpy 'cobblestone' tissue that bleeds easily.

Normal Healing Signs

• Red/pink granulation tissue = positive sign
• Decrease in wound size over time
• Serous to minimal serosanguineous drainage
• Gradual epithelialization at edges

Abnormal Findings

• Pale/dusky granulation: poor perfusion or nutrition
• Hypergranulation: excess overgrowth ('proud flesh'). May need silver nitrate or pressure
• Necrotic tissue: requires debridement

Nursing Considerations

Maintain a moist wound environment (appropriate dressing), protect granulation during dressing changes. Do not disturb new tissue. Promote healing with adequate protein, vitamin C, zinc, and glycemic control, such as address underlying issues (smoking cessation, pressure relief).

NCLEX Relevance

Beefy red granulation = positive sign of healing.