What this experience covers
This is a composite account of what people experience when they notice granulation tissue in their fistula wound — the questions it raises, the anxiety it creates, and what it actually means for healing. It draws from many anonymised stories.
The pattern
What granulation tissue looks like
People describe noticing tissue in the wound that looks different from what they expected:
- Red or pinkish tissue that appears bumpy or granular
- Tissue that looks moist and slightly raised
- Sometimes described as “proud flesh” when it grows above the wound surface
- It can bleed easily when touched or during cleaning
Is it good or bad?
The short answer: granulation tissue is generally a positive sign. It indicates that the body is building new tissue to fill the wound. It is a normal and expected part of healing by secondary intention (how open fistula wounds heal).
However, excessive granulation tissue — tissue that grows above the wound surface (hypergranulation or “proud flesh”) — can delay healing by preventing the skin from closing over the top. This is not dangerous, but it may need attention from your surgical team.
What people find confusing
The main source of anxiety: granulation tissue can look alarming if you do not know what it is. It is red, moist, and bleeds easily — all of which trigger worry. People frequently describe searching online, seeing images, and becoming more anxious rather than less.
The reassurance from many accounts: granulation tissue in a fistula wound is expected and normal. If you are concerned about its appearance, a quick check with your surgical team can confirm whether healing is progressing as expected.
If something about your recovery does not feel right, or you just want reassurance about what is normal, our chat can help you think it through.
When to contact your doctor
Seek medical attention if you experience:
- Increasing pain, swelling, or redness near the anus
- Fever or chills
- Pus or foul-smelling discharge
- New or worsening symptoms after surgery