Silver nitrate for granuloma (1212)

Silver nitrate can be used to treat granulation tissue at G-tube, J-tube, GJ-tube and trach sites.

What is silver nitrate?

It is a medicine on a wooden stick.

Why is silver nitrate used?

It is used to shrink and get rid of extra skin tissue called granulation tissue. The medicine can be used on the granulation tissue around feeding tubes on the belly and tracheostomy tubes.

What is granulation tissue?

It is extra skin tissue that grows on wounds as they are healing.

How do I use the silver nitrate?

Only use the medicine after talking with your child’s doctor or nurse. Do not use the medicine if you were not shown how to use it. Do not use around trach tubes if the granulation tissue is all the way around the trach stoma.

Follow these steps to use the medicine. Have someone help you hold your child so they do not move a lot.

Feeding tubes	Trach tubes
1. Get your supplies - Gloves - Gauze - Silver nitrate - Vaseline or barrier cream	1. Get your supplies - Gloves - Gauze or Mepilex - Silver nitrate
2. Wash your hands.	2. Wash your hands.
3. Put gloves on to protect your hands.	3. Put gloves on to protect your hands.
4. Use your finger to spread Vaseline or barrier cream on the skin around the granulation tissue. Do not use Vaseline on trach sites. This can be harmful.	4. Use gauze to remove any moisture at the stoma before you use the silver nitrate. Do not use Vaseline on trach sites. This can be harmful.
5. Take one stick and dab or roll on the granulation tissue. It will turn a gray or white color when treated. The medicine on the stick will turn from brown to white. This is normal. Keep putting the medicine on the granulation tissue until it is all treated.	5. Take one stick and dab or roll on the granulation tissue. It will turn a gray or white color when treated. The medicine on the stick will turn from brown to white. This is normal. Keep putting the medicine on the granulation tissue until it is all treated.
6. Blot the skin with gauze every couple times you dab the skin. This helps soak up extra medicine instead of staying on the skin.	6. Blot the skin with gauze every couple times you dab the skin. This helps soak up extra medicine instead of staying on the skin.
7. After all the granulation tissue is treated, put a split gauze on the skin for one hour. This will help soak up any drainage.	7. After all the granulation tissue is treated, leave the area open to air for at least 4 to 5 hours.
8. Put the used stick in a plastic bag and seal it. Throw the bag in the garbage.	8. Put the used stick in a plastic bag and seal it. Throw the bag in the garbage.
10. Remove or change the split gauze after one hour.	10. If your child uses a trach dressing, may place it on after 4 to 5 hours.

What happens to the tissue after the medicine is used?

The treated granulation tissue will dry up and fall off. This may take 1 to 2 days.

How do I know if I should use more medicine on the tissue?

Follow your child’s doctor or nurse’s directions. Wait 24 hours before using the medicine again. Do not use more than 5 days in a row.

How do I store the silver nitrate?

Keep the medicine sticks in the package. Store the package in a safe place. Keep out of reach of children and pets. Throw away any expired medicine in a sealed plastic bag. Do not flush down a
toilet.

What do I do with the medicine after my child’s granulation tissue is gone?

You can keep the medicine if it is in a safe place and not expired. Your child’s doctor or nurse may tell you to use the medicine again.

Special information

The site may be sore after this medicine is applied. The medicine can cause some stinging. This goes away after a few minutes.

Sometimes silver nitrate may cause a mild skin injury. This is rare. The skin can be burned and red. It will heal. Do not let the medicine touch any other skin or surfaces.
Stop using the medicine if skin around the tube is stained, open, blistered or peeling. The dark color will go away, but it may take up to one week. Check the size of the granulation tissue every day with cares.

Other teaching sheets that may be helpful

3005 Feeding tube granulation tissue

This sheet was created to help you care for your child or family member. It does not take the place of medical care. Talk with your healthcare provider for diagnosis, treatment and follow-up.