What Is Granulation? The Process Of Donald Trump's Healing Ear Explained

Congressman and former White House doctor under the Trump administration Ronny Jackson has issued media statements regarding his recent observations of former President Donald Trump's ear injury following an assassination attempt at a Pennsylvania rally on Saturday, July 13 (per The New York Times). The Republican nominee was reported to have been shot by a gunman during the event, which resulted in two other people being injured and one dying, reports CBS News.

Jackson disclosed being a friend of the politician, sharing that he had flown with Trump on Sunday, July 14 for the Republican National Convention taking place in Milwaukee. During the flight, Jackson tended to Trump's wound, changing out the gauze dressing on his ear. 

As of yet, no representative from the former president's team has issued any official statement regarding Trump's medical status. Jackson, who TMZ reports is still Trump's current physician, did however share details about what he saw underneath the bandage and the process behind the ear's healing.

"The bullet took a little bit off the top of his ear in an area that, just by nature, bleeds like crazy," Jackson stated in a press release, as reported by The New York Times. More specifically, the former White House doctor stated that the skin and cartilage on Trump's upper ear appeared to have been completely severed, which is why routine changing of the dressing was necessary. "The dressing [is] bulked up a bit because you need a bit of absorbent. You don't want to be walking around with bloody gauze on his ear," he stated. 

In terms of any additional head injuries, the Republican Representative of Texas further stated that Trump did not experience a concussion following the injury (via Newsweek). Jackson added that he believes it was the timing and manner in which Trump turned his head during his speech that prevented the bullet from going into his head.

Jackson has also publicly voiced that the former president's ear will not likely need any additional medical attention, as it is expected to heal on its own through granulation — or the process of new connective tissue repair — which he says will minimize the appearance of the injury.

Cleveland Clinic experts explain that outer ear injuries most often take three different forms: minor cuts or scrapes, subperichondrial hematoma (in which blood collects under the skin's surface), or avulsion, in which part of the ear is either partially or entirely torn off due to injury — such as in Donald Trump's case. In some instances, surgery may be needed to repair the damage.

The Wound Pros state that granulation is a key part of the healing process. During granulation, new connective tissue and small blood vessels form in the wound. The newly formed tissue can be pink or red, per the source, and it has a "bumpy" appearance. They explain that it acts as a scaffold for new tissue and blood vessels to form, filling in the healing wound.

According to an updated 2023 continuing education activity published in StatPearls, the ears are at an increased risk for lacerations due to their anatomical structure. Our ear skin receives its blood supply from offshoots of two different arteries, yet the ear lobes receive relatively minimal blood flow (per Faces PLLC). For this reason, time is of the essence when it comes to repairing ear injuries, otherwise, a person is at greater risk for permanent tissue damage. 

In the event of an ear tear, apply pressure to the area with a clean washcloth or gauze to reduce bleeding. Do not put ice in direct contact with the skin, which can exacerbate pain, hinder blood flow, and prolong healing. Instead, use a cool compress to alleviate swelling and seek urgent medical care. For children, experts at Children's Hospital of Philadelphia state that caregivers will also want to reach out to their pediatrician if an ear laceration is larger than ½ inch in depth or length. The same is true if symptoms of discharge, redness, or warmth develop, indicating possible wound infection.