Hypergranulation Tissue Not Healing After 2 Months of Silver Nitrate - Advise? (photo)

this is not granulation, this is an open wound that either 1) needs to be surgically revised or 2) wound vac and wound healing to improve this.

RosySo sorry you are having this issue. Since the wound care regimen of silver nitrate is not working, it sounds like other wound healing medications may be a better choice. Ask your plastic surgeon for a referral to a wound care specialist or simply ask for a different wound care regimen. Good luck.

Dear rosygal07,
I'm sorry to hear about your complication. It is hard to tell for sure without an examination, but based on your photo, it looks like your wound is clean and has some drainage. I would suggest you to follow your surgeon's instructions and keep your wound clean and covered. 
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

 It's not appropriate for any other doctor to change your postoperative protocols so you should check in with your doctor. you don't look like you have hyper granulation at all based on the picture.  If you were my patient I would stop the silver nitrate. Personally for patients to develop granulomas or hyper granulation I prefer steroid injections over the use of silver nitrate.  There are two reasons your world is not healing. Either the silver nitrate is blocking the granulation tissue from forming at all whi  If you were my patient I would probably stop the silver nitrate at this point and change to wet to dry dressing's.  Best, Mats Hagstrom MD 

There are several things wrong with this scenario. First, there is no hypertrophic granulation tissue present in the wound in the picture. Secondly, If you originally had that, then 1 or 2 applications of silver nitrate by the physician would be enough together with other wound care. It is totally inappropriate for the patient to be using silver nitrate on the wound regularly. The result is a wound that just doesn't heal because all the cells that would heal it are continually being killed by the silver nitrate. (50 years ago professionals used dilute silver nitrate as an antibiotic solution on large burns, but not since. Silver is still presently used, but in medications like Silvadene as an antibiotic.) Thirdly, any infection or problem with healing of a liposuction access port, particularly in the neck where the incisions are about 1/8 inch long, is an extremely rare problem, especially among experts. I would start by discussing this with your surgeon and, if a changed approach does not improve the problem rapidly, I would seek another opinion.