Which agent is commonly used for cauterization of excessive granulation tissue around a PEG site?

• A. Iodine
• B. Alcohol
• C. Hydrogen peroxide
• D. Silver nitrate sticks

Answer: (D)

Exuberant granulation tissue around a PEG site is best treated with a chemical cauterant that selectively destroys the excess tissue while minimizing damage to surrounding skin. Silver nitrate sticks provide targeted cauterization by applying a caustic solution directly to the granulation tissue, causing local protein denaturation and controlled necrosis. This reduces the excess tissue quickly and helps the stoma sit properly, often with only brief tissue discoloration as the treated tissue sloughs away.

To use correctly, the applicator is kept to the granulation tissue for a brief contact, with surrounding skin protected, then the area is gently rinsed and cleaned. Re-treatment may be needed if regrowth occurs. Other agents like iodine, alcohol, and hydrogen peroxide are antiseptics or cleansing agents that can irritate mucosa or delay healing, and they don’t provide the same controlled, localized tissue destruction as silver nitrate.