Nail Fold Inflammation and Granulation Tissue Healing

181837 Paronychia and Granuloma

Hello Dr.
Wu, thank you for your response.
I am referring to case #181837 regarding paronychia and granulation tissue.
Due to poor results from cryotherapy, the doctor later surgically excised the granulation tissue, but during the procedure, silver nitrate was applied.
Consequently, there has been no significant improvement in the healing of the tissue, as shown in the images below.
Could you please advise how long it will take for this wound to improve and when it can be exposed to water? Is there a better treatment option available? The doctor prescribed Tannic Acid Cream for me to apply, and the surface of the wound is hard, but it has not healed.
I have already spent two months dealing with this finger.
I kindly request your guidance.

[Images linked]

AA, 60~69 year old female. Ask Date: 2022/06/05

Dr. Wu Yuxin reply Dermatology

I cannot provide recommendations online, as this would violate medical regulations.
For this issue, you should consult your attending physician, as they are most familiar with your condition and can help you choose the appropriate medication or treatment method.

Reply Date: 2022/06/05

More Info

Nail fold inflammation, also known as paronychia, and the healing of granulation tissue can be complex processes, especially when surgical intervention and chemical agents like silver nitrate are involved. In your case, it appears that after the surgical removal of the granulation tissue, you have been experiencing slow healing, which is not uncommon in such situations.

Granulation tissue is a type of connective tissue that forms during the healing process. It is characterized by the presence of new blood vessels, inflammatory cells, and fibroblasts. This tissue is essential for wound healing, but its formation can be influenced by various factors, including infection, moisture, and the presence of foreign materials.

The use of silver nitrate in your treatment may have contributed to the hardening of the wound surface. Silver nitrate is often used to cauterize tissue and can help reduce granulation tissue formation, but it can also lead to delayed healing if the tissue becomes necrotic or overly dry. The hard surface you are observing may indicate that the tissue is not adequately hydrated, which is crucial for proper healing.

In terms of healing time, it can vary significantly based on the individual, the extent of the injury, and the treatment methods employed. Generally, soft tissue injuries can take anywhere from a few weeks to several months to heal completely. Given that you have been dealing with this issue for two months, it is essential to continue monitoring the wound for signs of infection, such as increased redness, swelling, or discharge.

Here are some recommendations for promoting healing and managing your wound:
1. Moisture Management: Keeping the wound moist can facilitate healing. Consider using a hydrogel or a specialized wound dressing that maintains a moist environment. This can help soften the hard surface and promote the growth of healthy granulation tissue.

2. Avoid Irritants: Protect the area from further irritation. Avoid exposing the wound to water until it has healed sufficiently. If you need to wash your hands, consider using gloves to protect the area.

3. Follow-Up Care: Regular follow-up with your healthcare provider is crucial. They can assess the healing progress and determine if further interventions are necessary, such as debridement or the use of different topical treatments.

4. Topical Treatments: If your doctor has prescribed a topical treatment like "燙膚舒" (which may refer to a soothing or healing ointment), ensure you apply it as directed. This can help reduce inflammation and promote healing.

5. Nutrition and Hydration: Ensure you are consuming a balanced diet rich in vitamins and minerals, particularly vitamin C and zinc, which are vital for wound healing. Staying hydrated is also essential for overall health and recovery.

6. Patience and Care: Healing can be a slow process, especially with complications. Be patient and continue to care for the wound as advised by your healthcare provider.

If you notice any signs of infection or if the wound does not show improvement in the coming weeks, it is crucial to seek medical attention promptly. Your healthcare provider may need to reassess the situation and consider alternative treatment options to facilitate healing.

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