Randomized clinical trial comparing silver nitrate application with topical corticosteroids for hyper-granulation tissue at gastrostomy sites

Gastrostomy tube (G-tube) insertion is one of the most commonly performed procedures in pediatric surgery. Complications from G-tubes are not uncommon and are a frequent reason for pediatric surgery office visits. The development of hyper-granulation tissue around the G-tube site is one of these complications. It is accompanied by chronic drainage and skin breakdown from the G-tube site resulting in localized irritation around the tube. Various treatments exist for hyper-granulation tissue that includes silver nitrate, topical corticosteroids, and intraregional injection of corticosteroids, sprinkling salt, laser therapy and surgical excision. These therapies have not been adequately evaluated to determine which is most effective. There have been no randomized trials comparing any of two of these treatments. The most common treatments are silver nitrate and topical corticosteroids; this study aims to compare the effectiveness of both.