Prevention of hypergranulation tissue after gastrostomy tube placement: A randomised controlled trial of hydrocolloid dressings

Hypergranulation tissue formation is a common complication after gastrostomy tube (G‐tube) placement, occurring in 44%–68% of children. Hydrocolloid dressings are often used in the treatment of hypergranulation tissue but have not been studied for the prevention of postoperative hypergranulation tissue. An institutional review board (IRB)‐approved, prospective, randomised study was performed in paediatric patients who underwent G‐tube placement at a single, large children's hospital from January 2011 to November 2016. After placement, patients were randomly assigned to (1) standard postoperative G‐tube care, (2) standard hydrocolloid G‐tube dressing, or (3) silver‐impregnated hydrocolloid G‐tube dressing, and the incidences of postoperative hypergranulation tissue formation, tube dislodgement, infection, and emergency department use were compared. A total of 171 patients were enrolled; 128 patients (75%) had at least 4 months of follow up and were included in the analyses. Eighty‐nine patients (69.5%) developed hypergranulation tissue during the postoperative period, with no significant differences in incidence among the three treatment arms. Of those who developed hypergranulation tissue, 46 (56%) visited the emergency department, compared with 6 of the 39 patients (19%) who did not develop hypergranulation tissue. Hydrocolloid dressings (standard or silver‐impregnated) do not prevent the development of hypergranulation tissue or other complications after G‐tube placement in paediatric patients.