Which of the following is true about granulation tissue around a PEG site?

• A. Excessive granulation is defined as > 0.25 inches in adults or > 2 mm in children
• B. Excessive granulation is defined as > 1 inch in adults
• C. Excessive granulation is defined as > 5 mm in children
• D. Excessive granulation is not defined by size

Answer: (A)

Hypergranulation tissue around a PEG site is tissue that rises above the level of the surrounding skin, and clinicians use size thresholds to decide when this is excessive. In adults, excessive granulation is defined as more than a quarter inch (about 6 mm) above the skin surface; in children, the threshold is more than 2 mm. These specific cutoffs acknowledge that pediatric tissue dynamics are different and require a smaller measurement to indicate overgrowth. The other options propose either much larger or smaller thresholds or deny any size criterion, which doesn’t match how hypergranulation is assessed in practice.