: How is moistness balanced with avoiding overgranulisation, in wound care? Assuming that infection, bleeding are taken care of, and/or for the purposes of this question can be ignored: I am trying to gain an understanding

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How is moistness balanced with avoiding overgranulisation, in wound care?
Assuming that infection, bleeding are taken care of, and/or for the purposes of this question can be ignored:

I am trying to gain an understanding of an aspect of wound care I don't yet really understand fully. This is roughly what I know that is relevant:

In a moderately serious wound, say to a limb or extremity, where some tissue was lost below skin level, the current advice is that moist healing will be faster and better quality than dry healing. The damaged tissue regenerates, and part of this process is the growth and vascularisation of granular tissue. Granular tissue can overgrow and lie proud above skin level, and may in some cases need to be cauterised or reduced if it does, so that epithelial healing and new surface skin can grow appropriately.

What puzzles me is, there is clearly a balance in wound management, as the tissue begins to regrow. On one hand, it must be allowed to heal in a moist environment, for quality and speed; on the other hand a moist environment promotes granular tissue which may then overgrow.

Presumably therefore as the regrowing tissue approaches or reaches natural "skin level", the wound environment must be modified slightly, so it's still moist enough to heal nicely, but no longer promotes any further granular development.

At this point, however, the healing wound may still be open flesh and vulnerable to dryness, UV, infection, dressing adhesion, and damage, and may even still be weeping/exuding in some cases. Despite this, the dressing and treatment must start to ensure isn't unconditionally moist. Rather, it must remain moist enough to heal nicely, but ensure that the wound environment is no longer favourable to further granularisation, and instead begins to develop an epithelial layer.

But how is this change achieved? What is required in wound care, and what must be modified in the wound dressings/environment, from that point onward, to encourage this?

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