DR P. MARAZZI / SCIENCE PHOTO LIBRARY DR P. MARAZZI / SCIENCE PHOTO LIBRARY
Granuloma in episiotomy scar. Close up of wound granulation (scar) tissue in a patient with a six month old episiotomy scar. The scar is being re- explored to find a granuloma (a hard swelling formed by chronic inflammation). The granulation tissue appears as spongy, pale tissue, grasped by the surgical forceps (at centre). The formation of thick scar tissue is a natural part of the healing process. Granulomas form as a local reaction to injury. The presence of certain infectious agents or foreign bodies causes excessive scar tissue to be formed. In this case the agent is likely to be a missed stitch. Treatment is surgical removal.
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