Granulation tissue is collagen-rich tissue which forms at the site of an injury. As the body heals, this tissue fills in the injury, and may eventually scar over. The scar may fade over time, especially if the wound is small. In some cases, the body produces too much granulation tissue, in a condition known as proud flesh, in which case medical treatment may be required to halt the overproduction.
The appearance of granulation tissue is a good sign. When a wound starts granulating, it means that the body is starting to rebuild after the injury. This highly fibrous tissue is usually pink because the body produces numerous small blood vessels to provide a supply of oxygen and nutrients to remove waste. It is also commonly bumpy and uneven, and may be moist to the touch. In the beginning, granulation tissue can look reddened and irritated, but this is simply because of the numerous blood vessels it contains.
In the case of proud flesh, the tissue overgrows. Doctors often treat this problem with topical applications which cauterize the granulation tissue so that it will stop growing, encouraging the body to move on to the next stage in healing. Sometimes more aggressive tactics such as surgery to remove the excess tissue may be necessary, depending on the specifics of the situation. A doctor can evaluate a given case and determine the most appropriate course for treatment.
People who have permanent catheters and ports implanted may develop granulation tissue around the site of the implant. This is especially common if the implant is not fitted properly or if it moves around, because the flesh is continually reinjured, and thus it produces granulation tissue to repair itself. It is important to maintain catheters, ports, and other implants with scrupulous care to avoid the development of granulation tissue along with complications like infections.
Sometimes, granulation tissue forms inside the body, and may cause stenosis, or narrowing. For example, if the trachea or esophagus are injured or irritated, the body can start to produce this fibrous tissue in an attempt at repair, and if it overgrows, these openings can narrow, causing difficulties with breathing and swallowing. There are treatments available for patients who experience conditions like tracheal stenosis, and people who are at risk may be advised to take steps to minimize the body's production of granulation tissue. It is not always possible to predict or prevent an overgrowth.