Granulation tissue in horses is a type of connective tissue that forms during the wound healing process. It is characterized by the presence of new capillaries, fibroblasts, and extracellular matrix. This tissue serves as a temporary framework over which new skin can develop, playing a significant role in the repair of tissue injuries. In equine medicine, excessive granulation tissue, commonly referred to as "proud flesh," can be a complication, particularly in wounds located on the limbs. The management and treatment of granulation tissue are important for promoting effective healing and preventing further complications. This page compiles peer-reviewed research studies and scholarly articles that explore the formation, regulation, and clinical management of granulation tissue in horses.
Dos Santos TS, Dillmann JB, Giovelli M, Elias GO, Lima RK, Cescon S, Stainki DR, Dos Santos RC, Corrêa C, Monteiro SG.This study reports the successful use of maggot therapy in four horses with traumatic wounds caused by wire fences, treated in veterinary clinics and under field conditions in southern Brazil. All lesions showed tissue necrosis, purulent discharge, and foul odor, indicating infection and delayed healing. Sterile Lucilia cuprina larvae (L1 stage) were applied directly to the wounds for 48 hours. Rapid improvement was observed, with marked reduction of necrotic tissue, exudate, and odor, and stimulation of granulation tissue in three cases. Complete wound closure occurred between 10 and 60 days ...
DiBello D, Cassel N, Granacka V, Beard L, Rosado SC, Hill-Thimmesch K, Avellar H.Equine sarcoidosis is an uncommon disease characterized by granulomatous inflammation presenting in a spectrum of body system involvement and severity. Musculoskeletal manifestations are sporadically reported but without correlation between imaging and pathologic findings. In a mature Quarter Horse mare eventually diagnosed with a progressive form of sarcoidosis, phalangeal osteolysis discovered on radiography prompted further evaluation, revealing diffuse, discrete osteolysis throughout the axial skeleton. Due to disease progression, humane euthanasia was elected, and computed tomography and ...
Partusch L, Rutland CS, Martens A, Du Cheyne C, De Spiegelaere W, Michler JK.Exuberant granulation tissue (EGT) is a second intention wound healing disorder. It commonly occurs in the distal limb of horses. EGT causes significant increase in the duration and cost of treatment, potentially leading to the decision not to pursue treatment and euthanize the patient. The underlying pathomechanisms of this fibroproliferative disorder remain unclear, particularly in terms of collagen composition and the association between myofibroblasts and blood vessels. This study investigated the collagen composition in naturally occurring EGT following trimming in 19 horses (EGT group). ...
Loyd A, Neto R, Caldwell F, Boone L, White A.This study aimed to determine the safety and macroscopic/microscopic effects of fluorescence biomodulation (FBM) on experimentally induced, full-thickness, distal limb wounds in horses.This was an experimental study ( = 6 horses). Two full-thickness wounds were created on both dorsal metacarpi of six adult horses. Each forelimb was randomly allocated to either control (no FBM) or treatment (FBM) and randomly allocated to visual or histological assessment of healing. Wounds were treated within each experimental group every 7 days for four treatments. Fluorescence biomodulation wounds were ...
Accorroni L, Dini F, Pilati N, Marchegiani A, Bazzano M, Spaterna A, Laus F.Wound management is a fundamental skill for veterinarians, requiring a systematic approach to wound care and a deep understanding of the biological principles underlying healing. Sucralfate, widely known as a mucoprotective agent for gastroduodenal ulcers, has recently shown promising topical effects in human skin lesions by binding and protecting growth factors from proteolytic degradation, thereby enhancing their local availability. This action promotes angiogenesis, chemotaxis and cell proliferation, while reducing oxidative stress and exerting bacteriostatic and bactericidal effects agains...
Kamm JL, Odegaard J, Gaida J, King N.This tutorial aims to illustrate and instruct on the technique of punch skin grafting in the horse. Unassigned: A 10-year-old paint gelding with a 9 X 6-cm chronic granulating wound to the left forelimb was utilized for this tutorial. Unassigned: The chronic wound was debrided with sharp dissection, and the limb was pressure bandaged overnight. Twenty-four hours later, the horse was sedated for punch skin grafting. The ventral pectoral region was aseptically prepared for skin harvest and locally anesthetized. An 8-mm biopsy punch was used to harvest the grafts. The subcutaneous tissue was then...
Holz N, Suárez J, Hetzel U, Rampazzo A, Stoppini R.A 15-year-old Swiss Warmblood gelding was presented to the ophthalmology service of Zurich University due to severe visual impairment. Ophthalmic and neurologic examinations were performed, raising suspicion of post-retinal blindness. Standing contrast computed tomography (CT) of the head revealed a partially calcified, soft tissue attenuating mass in the sphenopalatine sinus with concurrent compression of the optic nerves and chiasm. Differential diagnosis included neoplasia and granulomatous disease. The horse was euthanized, and the head was subsequently examined by magnetic resonance imagi...
Pressanto MC, Bombonato C, Foote AK, Coomer RPC.To describe dermoid cyst formation as an uncommon complication of the pinch grafting technique in horses. Methods: Case report. Methods: A 8 year old Arabian gelding. Methods: Clinical presentation, imaging, treatment, and histopathology records were reviewed. The horse originally presented due to delayed healing of a laceration to the distal aspect of the metatarsus. The wound was treated initially with debridement and it was allowed to fill with healthy granulation tissue prior to pinch grafting. Two months after grafting, the horse started to show self-mutilation behavior targeting the woun...
Salciccia A, de la Rebière de Pouyade G, Caudron I, Ponthier J, Serteyn D, Sandersen C, Deleuze S, Grulke S.Although rarely fatal, complications of ventral midline laparotomy incision in equine patients increase hospitalization cost and duration and may jeopardize return to athletic function. Therefore, many techniques have been developed to reduce their occurrence and expedite their resolution when they occur. Our technique of celiotomy incision closure includes the use of tension sutures (vertical U mattress) of polyglactin 910 on the linea alba, which is then apposed by polyglactin 910 interrupted sutures or a simple continuous pattern suture with a stop midway before routine closure of the super...
Charlotte C P, Benoit B, Olivier M L.To evaluate secondary intention wound healing in the horse's limbs when treated with the synthetic epidermis spray (Novacika®, Cohesive S.A.S, France) or with a standard bandaging technique. Methods: Six Standardbred mares were included in the study. Four 2.5 x 2.5 cm full-thickness skin wounds were created on each thoracic limb. Two wounds were located on the dorsoproximal aspect of the cannon bone and the other two at the dorsoproximal aspect of the fetlock. Six hours after creation, wounds were randomly treated with synthetic epidermis spray or standard bandaging. The wounds were assessed ...
Williams ZJ, Pezzanite LM, Hendrickson DA.Skin grafting is a simple technique that can be performed by equine practitioners to improve cosmetic outcomes in wounds with large skin defects that would not heal functionally or cosmetically with standard wound therapy interventions. Successful skin grafting is not difficult but relies upon appropriate preparation of the wound bed and effective immobilisation of the grafted area after skin graft placement. Prior to grafting, the wound bed should be treated with a moist wound healing dressing to prepare the granulation tissue bed to receive the graft. For best results, skin grafts should be ...
Tallon RE, Gough RL, McGovern KF.To describe the use of an equine compression suit to manage a deep axillary wound in a Thoroughbred filly with bilateral pneumothorax. Methods: A 2-year-old Thoroughbred filly was referred for management of a deep wound to the left axilla. Packing and bandaging of the area were initially attempted, but this became repeatedly dislodged, and bandaging was discontinued. The filly subsequently developed widespread subcutaneous emphysema, and the wound was slow to granulate. Acute onset respiratory distress occurred 11 days after admission, secondary to bilateral worsening pneumothorax, and requir...
Chevalier JM, Pearson GB.The objective of this study was to report clinical outcomes of horses with naturally occurring full-thickness skin lacerations treated with an amorphous silicate dressing. We hypothesized that wounds treated with an amorphous silicate dressing would have minimal complications and lesion resolution without formation of exuberant granulation tissue. 11 client-owned horses. Clinical records of 11 horses with distal limb wounds treated with an amorphous silicate dressing were collected from participating veterinarians across the US. Wound healing progression was monitored by the veterinarian and o...
Rosa MVD, Rosa M, Botteon PTL.This study aimed to evaluate the use of equine amniotic membrane (EAM), frozen indirectly using liquid nitrogen and stored between -10° and -24°C, in the treatment of equine skin lesions. Six healthy female horses, aged 3-10 years, were included in this study. EAM was collected from previously evaluated healthy parturient mares. Wounds were surgically created at the distal ends of the forelimbs. One limb was chosen for treatment, and the contralateral limb was chosen as the control. Pain sensitivity, presence of granulation tissue, secretions, and bleeding after debridement during cleaning w...
Regnier A, Landrevie C, Robin MC, Einsweiler D, Douet JY, Raymond-Letron I.A 6-year-old miniature Shetland pony mare was referred for evaluation of a left corneal mass, which developed from the healing tissue of a corneal traumatic ulceration that had occurred 4 weeks previously. On gross examination, a spherical, smooth-surfaced, and pink-colored lesion of about 1 cm in diameter was protruding from the left palpebral fissure. Ophthalmic examination revealed that it was attached to the scar tissue of the cornea, and that one corpora nigra was adherent to the posterior face of corneal wounded area, without sign of uveitis. The remainder of the ophthalmic examinatio...
Anantama NA, Du Cheyne C, Martens A, Roth SP, Burk J, De Spiegelaere W, Michler JK.Exuberant granulation tissue (EGT) is often observed during second intention wound healing in horses. Despite its impact on wound care, the basic mechanisms leading to EGT are still unclear and effective strategies to prevent and/or treat EGT are lacking. The development of EGT is a poorly understood, multifactorial process involving hyperproliferating fibroblasts and malfunctional differentiation of keratinocytes, suboptimal wound contraction, dysfunctional vascularisation, and chronic inflammation. To consolidate and describe basic and clinical research literature on EGT and to identify know...
Du Cheyne C, Martens A, De Spiegelaere W.Exuberant granulation tissue (EGT) is a frequently encountered complication during second intention healing in equine distal limb wounds. Although it is still unknown what exactly triggers the formation of this tissue, previous research has revealed a persistent inflammatory response in these wounds. In this preliminary study we examined this inflammatory response in EGT-developing wounds as well as in experimental induced wounds. Immunohistological stainings were performed to detect primary inflammatory immune cells (MAC387 staining) as well as pro-resolution immune cells (CD163 staining). Ou...
Atiba A, Ghazy A, Hamad MH.Cutaneous pythiosis in horses is a chronic ulcerative granulomatous disease caused by the oomycete Pythium insidiosum. Objective: The objective of the present study was to evaluate the response of cutaneous pythiosis in horses to surgical excision and topical dimethyl sulphoxide (DMSO). Methods: Thirty horses were presented clinically with pruritus, fistulae discharging serosanguineous fluid, and output kunkers in different body areas (limb, abdomen, neck, and face). The clinical diagnosis was confirmed by isolation of the causative agent and histopathology. All animals were treated by surgica...
Kalamanova A, Anderson BH, Cust AR, Fulton IC.There are several skin grafting methods described in the human and animal literature. Currently, there are five types of free grafts used in horses: pinch and punch grafts, split and full-thickness sheet or mesh grafts and tunnel grafts. Published methods of tunnel grafting describe the use of alligator forceps. The alligator forceps create a poor tunnel and are excessively traumatic to the granulation bed. This technique utilised a 13G Jamshidi needle that was placed across the granulation bed and created a uniform tunnel. The Jamshidi needle was atraumatic to the granulation bed increasing t...
Wilmink JM, Ladefoged S, Jongbloets A, Vernooij JCM.The effect of dressings saturated with either a standardized suspension of probiotic bacteria or saline on healing of traumatic distal limb wounds in horses was evaluated for 24 days, and the systemic inflammatory effect was assessed. The wounds were divided in two groups based on the phase of healing: wounds with an incomplete (ICGB) or a complete granulation bed (CGB). The wound area was expressed as percentage of the wound area at day 0 and defined as relative wound area. The mean relative wound area decreased faster in probiotic than saline treated wounds. The difference was most obvious i...
Dedar RK, Kumar N, Narnaware SD, Tripathi BN.Wound healing in horses is complicated by the excessive growth of granulation tissue, commonly known as proud flesh and is similar to keloids in human beings. At present, there is no satisfactory treatment for proud flesh in horses. In this study, we, for the first time, demonstrated that leaf extract of Aerva javanica suppresses excessive growth of granulation tissue in horses. Many plant flavonoids are claimed to have antiproliferative properties. Kaempferol is a natural flavonoid containing 3-hydroxy flavone backbone found in many plants in its aglycone form and attached with various sugars...
Dubuc V, Laverty S, Richard H, Doré M, Theoret C.There is a growing interest in the scientific community to use computer-based software programs for the quantification of cells during physiological and pathophysiological processes. Drawbacks of computer-based methods currently used to quantify immunohistochemical staining are the complexity of use, expense of software and overly-simplified descriptions of protocol thereby limiting reproducibility. The precise role of mast cells in equine cutaneous wound healing is unknown. Given the contribution of mast cells to the chronic inflammation observed in human keloid, a pathology similar to exuber...
Leonardi F, Angelone M, Biacca C, Battaglia B, Pecorari L, Conti V, Costa GL, Ramoni R, Grolli S.Keratoma is a nonmalignant horse tumor that grows in the space between the horn of the hoof and the distal phalanx. Keratoma causes lameness in the horse, and surgical excision is the treatment of choice. Four horses underwent removal of a keratoma by complete hoof wall resection. The remaining wound was treated with platelet-rich plasma (PRP) combined with a sterile three-dimensional polylactic acid scaffold. The PRP was applied at 3, 6, 9, 12, 15, and 18 days postoperatively. The surgical site was cleaned with gauzes and swabs soaked in Ringer's lactate solution before applying PRP and the ...
Dahlgren LA.Wound management in horses can strike fear in some and passion in others. Wounds are common injuries in horses of all descriptions and requires exceptional knowledge and care to achieve a successful outcome. New treatments to overcome the critical challenges with equine wounds are always desired: managing dehisced and/or nonhealing wounds, managing exuberant granulation tissue, and ultimately achieving a functional tissue coverage. Regenerative medicine represents a broad set of tools with great promise to manipulate the deficiencies recognized in equine wound healing and improve the outcome.
Eggleston RB.Distal limb wounds in horses heal substantially different than trunk wounds, commonly resulting in exuberant granulation tissue and exposed and sequestered bone. Surgical intervention of severe rectovaginal lacerations in the mare should be delayed until the tissues have heeled and scar tissue has remodeled. Wounds resulting in severe hemorrhage require appropriate emergent fluid therapy and potentially transfusion therapy.
Varasano V, Marruchella G, Petrizzi L.The healing of wounds located on the equine distal limbs can often be impaired, which can result in exuberant granulation tissue and its associated aesthetic alteration and functional failures. Although a number of therapies have been developed and assessed, the treatment of these wounds still presents challenges. This report describes the treatment of exuberant granulation tissue in a horse using an intra-lesional injection of 4% formaldehyde solution. The successful outcome of this treatment suggests that further investigations are required in order to better evaluate its efficacy, as well a...
Mund SJK, Corbett C, MacPhee DJ, Campbell J, Honaramooz A, Wobeser B, Barber SM.Horses often sustain cutaneous wounds and healing can be prolonged and difficult to treat. Compared to body wounds, limb wounds heal slower and are more likely to develop exuberant granulation tissue. Differences in healing rates and exuberant granulation tissue formation is attributed to abnormal cytokine profiles. CXCL8 and its receptor CXCR2 are involved in acute inflammation whereas CXCL10 and its receptor CXCR3 are involved in inflammation resolution. β- arrestin-2 regulates inflammation through internalization of G-protein coupled receptors (GPCRs) including CXCR2 and CXCR3. Gene expres...
Wise LM, Bodaan CJ, Stuart GS, Real NC, Lateef Z, Mercer AA, Riley CB, Theoret CL.Bandaging of limb wounds in horses leads to formation of exuberant granulation tissue (EGT) that retards healing due to protracted inflammation, aberrant vascularisation and delayed epithelialisation. EGT is not observed if wounds are left undressed or when wounds are on the body. A previous study showed that short-term administration of proteins derived from orf virus dampened inflammation and promoted epithelialisation of open wounds in horses. Here, we investigated the impact of orf virus interleukin-10 and vascular endothelial growth factor-E on the development and resolution of EGT. Excis...
Smith RK, Zunino L, Webbon PM, Heinegård D.A protein prominent in guanidine hydrochloride extracts of adult bovine and equine digital flexor tendons was confirmed to be Cartilage Oligomeric Matrix Protein (COMP) by non-reducing and reducing SDS-PAGE, reaction with rabbit anti-COMP polyclonal antiserum on Western blots, trypsin digestion followed by HPLC on a C2/C18 column, and identification of COMP mRNA from tendon on Northern blots. Immunohistochemistry and Western blots of extracts showed COMP to be present in all regions of digital flexor tendons. Equine tendon COMP was purified by ion exchange chromatography and gel filtration and...
Theoret CL, Wilmink JM.Impaired wound healing represents an enormous clinical and financial problem for companion animals and humans alike. Unfortunately, most models used to study healing rely on rodents, which have significant differences in the healing and scarring process and rarely develop complications. In order to better simulate impaired healing, the model should strive to reproduce the natural processes of healing and delayed healing. Wounds on the limbs of horses display similarities to wounds in humans in their epithelialization/contraction ratio, genetic influence as well as dysregulated cytokine profile...
Monteiro SO, Lepage OM, Theoret CL.To evaluate the effect of platelet-rich plasma on wounds on the distal aspect of the forelimb in horses. Methods: 6 mixed-breed 10- to 15-year-old mares. Methods: 3 wounds were created on metacarpal regions in each of 6 horses (n = 36 wounds total). Eighteen wounds were treated with platelet-rich plasma and bandaged, whereas 18 control wounds were similarly bandaged with no prior topical treatment. Decrease in wound surface area and the required number of excisions of exuberant granulation tissue were recorded until complete healing. Tissue specimens were taken from wounds at 1 week for histol...
Theoret CL, Olutoye OO, Parnell LK, Hicks J.To compare histopathologic features of a fibroproliferative disorder in horses (exuberant granulation tissue-EGT) and people (keloid). Methods: Archival tissue samples of EGT (n = 8) and keloid (12). Methods: After automated hematoxylin and eosin, histochemical (Gomori trichrome, Verhoeff-van Gieson elastin) and immunohistochemical (vimentin, α-smooth muscle actin, CD34, CD68, CD117) stainings, tissue sections were evaluated using a semi-quantitative grading scale for presence or absence of ulceration, keloidal collagen, myofibroblasts, and elastic fibers as well as degree of inflammation, fi...
van Schie HT, Bakker EM, Jonker AM, van Weeren PR.To describe a method of computerized ultrasonographic tissue characterization that includes structures below the size limits of resolution in equine superficial digital flexor tendons. Methods: 2 damaged and 2 structurally normal superficial digital flexor tendons. Methods: Transverse ultrasonographic images were collected along the tendon long axis. Stability of echo pattern was quantified by means of variation in gray levels of each pixel in contiguous images and expressed as correlation, entropy, and waviness ratios. Results: Normal young and normal old tissues were characterized by high co...
Wilmink JM, van Weeren PR, Stolk PW, Van Mil FN, Barneveld A.The histological aspects of second-intention healing were studied in 5 horses and 5 ponies. Biopsies were taken weekly from standardised wounds on the metatarsus and femoral biceps muscle of one horse and one pony. Sections were stained to enable cell counting and the detection of DNA synthesis, fibrin, smooth muscle actin (SMA), collagen, and bacteria. In the ponies, the number of polymorphonuclear leucocytes (PMNs) was high during the first 3 weeks and subsequently decreased rapidly. In the horses, the initial number of PMNs was lower, but remained persistently elevated during the evaluation...
Lepault E, Céleste C, Doré M, Martineau D, Theoret CL.Wound repair in horse limbs is often complicated by exuberant granulation tissue, a condition characterized by excessive fibroplasia and scarring and that resembles hypertrophic scars and keloids in man. The aim of this study was to compare microvascular occlusion and apoptosis in wounds of the limb with those of the body, which heal normally. Five 6.25 cm(2) wounds were created on both forelimbs and on the body of six horses. One limb was bandaged to stimulate excessive fibroplasia. Weekly biopsies were evaluated histologically and immunohistochemically for mutant p53 protein by terminal deox...
Wilmink JM, Stolk PW, van Weeren PR, Barneveld A.Second-intention healing of deep wounds was studied in 5 horses and 5 ponies. Standardised wounds were created on the distal limbs and hind quarters. Wounds on the metatarsi extended onto the metatarsal bone; the depth of the wounds in the femoral biceps muscle was 18 mm. The wound margins were marked by tattoos. Photographs were taken at weekly intervals to determine the wound area. The relative contribution of contraction and epithelialisation to wound closure was quantified by means of the tattoos. Swelling of the limbs was measured; and regularity and aspect of the granulation tissue were ...
Hanson RR.Complications of wounds and cosmetic surgery can be accurately managed with a combination of timely surgical and medical intervention to ensure the best possible outcome. The lack of soft tissue protection and a large quantity of susceptible synovial, tendon, ligament, and neurovascular structures make early and meticulous evaluation of limb wounds critical. Skin grafting is usually used following a period of open wound management and after healthy granulation tissue formation. Penetrating wounds of the abdomen or thorax have a guarded prognosis resulting from the ensuing potential for infecti...
Theoret CL, Barber SM, Moyana TN, Gordon JR.To map the expression of transforming growth factor (TGF)-beta(1), TGF-beta(3), and basic fibroblast growth factor (bFGF) in full-thickness skin wounds of the horse. To determine whether their expression differs between limbs and thorax, to understand the pathogenesis of exuberant granulation tissue. Methods: Six wounds were created on one lateral metacarpal area and one midthoracic area of each horse. Sequential wound biopsies allowed comparison of the temporal expression of growth factors between limb and thoracic wounds. Methods: Four 2- to 4-year-old horses. Methods: Wounds were assessed g...
Celeste CJ, Deschesne K, Riley CB, Theoret CL.To map skin temperature kinetics, and by extension skin blood flow throughout normal or abnormal repair of full-thickness cutaneous wounds created on the horse body and limb, using infrared thermography. Methods: Experimental. Methods: Standardbreds (n = 6), aged 3-4 years. Methods: Three cutaneous wounds were created on the dorsolateral surface of each metacarpus and on the lateral thoracic wall. Thoracic skin wounds and those on 1 randomly chosen forelimb healed by second intention without a bandage, whereas contralateral limb wounds were bandaged to induce formation of exuberant granulation...
Theoret CL, Barber SM, Moyana TN, Gordon JR.To determine whether transforming growth factor (TGF)-beta1 and -beta3 expression differs between equine limb wounds healing normally and those healing with experimentally induced exuberant granulation tissue (EGT). Methods: Six wounds were created on the lateral aspect of both metacarpi of each horse; one forelimb was untreated, and the other was bandaged to stimulate the development of EGT. Sequential wound biopsies allowed comparison of growth factor expression between the two types of wound. Methods: Four horses (2 to 4 years of age; 350 to 420 kg). Methods: Wounds were assessed grossly, h...
Wise LM, Bodaan CJ, Stuart GS, Real NC, Lateef Z, Mercer AA, Riley CB, Theoret CL.Bandaging of limb wounds in horses leads to formation of exuberant granulation tissue (EGT) that retards healing due to protracted inflammation, aberrant vascularisation and delayed epithelialisation. EGT is not observed if wounds are left undressed or when wounds are on the body. A previous study showed that short-term administration of proteins derived from orf virus dampened inflammation and promoted epithelialisation of open wounds in horses. Here, we investigated the impact of orf virus interleukin-10 and vascular endothelial growth factor-E on the development and resolution of EGT. Excis...
Bigbie RB, Schumacher J, Swaim SF, Purohit RC, Wright JC.Equine amnion and live yeast cell derivative were evaluated as a biological dressing and as a topical wound medicament respectively, in the treatment of granulating wounds of the distal portion of the limbs of horses. Wounds measuring 2.5 x 2.5 cm were created on the dorsomedial aspect of the metacarpal and metatarsal region of all 4 limbs of 9 horses. Each wound was assigned randomly to 1 of 3 treatment groups: group C, treated with a nonadherent bandage as a control; group A, treated with amnion beneath a nonadherent bandage; and group L, treated with live yeast cell derivative beneath a non...
Link KA, Koenig JB, Silveira A, Plattner BL, Lillie BN.To compare the effect of extracorporeal shock wave therapy (ESWT) on expression of fibroblast growth factor-7 (FGF-7), transforming growth factor-β1 (TGF-β1), insulin-like growth factor-1 (IGF-1), platelet-derived growth factor-A (PDGF), and vascular endothelial growth factor-A (VEGF) in skin with surgically created skin wounds and intact skin in horses. Methods: 14 healthy horses. Methods: 8 horses were treated with ESWT at 6 locations along the neck at 36, 24, 12, 6, 2, or 1 hour prior to collection of full-thickness biopsy specimens from each location; a control specimen was collected fro...
Martins TB, Kommers GD, Trost ME, Inkelmann MA, Fighera RA, Schild AL.Twenty-one cases of pythiosis in horses (n = 10), dogs (n = 9) and cattle (n = 2) were investigated. The aetiology in all cases was confirmed by immunohistochemistry. Data related to the clinical course and outcome and localization of the lesions were obtained from pathology reports. The equine lesions consisted of fibrotic tissue with multiple, often coalescing, areas of immature granulation tissue encircling eosinophilic cores. Affected dogs had gastrointestinal and/or cutaneous lesions with either or both of a granulomatous/pyogranulomatous or necrotizing eosinophilic inflammatory reaction....
van Schie HT, Bakker EM, Jonker AM, van Weeren PR.To evaluate effectiveness of computerized discrimination between structure-related and non-structure-related echoes in ultrasonographic images for quantitative evaluation of tendon structural integrity in horses. Methods: 4 superficial digital flexor tendons (2 damaged tendons, 2 normal tendons). Methods: Transverse ultrasonographic images that precisely matched histologic sections were obtained in fixed steps along the long axis of each tendon. Distribution, intensity, and delineation of structure-related echoes, quantitatively expressed as the correlation ratio and steadiness ratio , were co...
Berry DB, Sullins KE.To determine whether povidone iodine ointment or 2 forms of silver sulfadiazine applied topically to wounds of the distal aspect of the limbs in horses affect the rate of second intention healing and to evaluate the additional influence of bandaging with these antimicrobials on granulation tissue formation. Methods: 6 healthy adult horses. Methods: Six standardized 2.5-cm2 skin wounds/horse were distributed between the dorsomedial surfaces of the metacarpi and metatarsi. One of the following 6 treatments was applied to each wound: 1% silver sulfadiazine cream with bandage, 1% silver sulfadiazi...
Broeckx SY, Borena BM, Van Hecke L, Chiers K, Maes S, Guest DJ, Meyer E, Duchateau L, Martens A, Spaas JH.Several studies report beneficial effects of autologous and allogeneic stem cells on wound healing. However, no comparison between autologous versus allogeneic epithelial-like stem cells (EpSCs) has been made so far. For this reason, we first hypothesize that both EpSC types enhance wound healing in comparison to vehicle treatment and untreated controls. Second, on the basis of other studies, we hypothesized that there would be no difference between autologous and allogeneic EpSCs. Methods: Twelve full-thickness skin wounds were created in six horses. Each horse was subjected to (i) autologous...
Marr CM, McMillan I, Boyd JS, Wright NG, Murray M.The ultrasonographic and histopathological findings in 12 normal and 28 injured superficial digital flexor tendons, with lesions ranging in duration from 2 days to 15 months, were compared. A consistent relationship between the ultrasonographic and histological findings was demonstrated. The echogenicity of lesions, the distinctness of their delineation from the surrounding tissue, and the presence and arrangement of the linear echoes were useful features by which to assess the ultrasonograms. Acute lesions were anechoic, a complex mixture of anechoic and hypoechoic areas, or diffusely hypoech...
van den Boom R, Wilmink JM, O'Kane S, Wood J, Ferguson MW.Wound healing in horses is often complicated by wound infection, exuberant granulation tissue, and hypertrophic scars, especially when wounds are located on the limbs. Wound healing in ponies is less problematic, characterized by a greater degree of wound contraction and a more intense initial inflammatory response. Because both processes are influenced by transforming growth factor-beta (TGF-beta), it was hypothesized that the better wound healing in ponies was associated with different TGF-beta profiles. A series of small wounds was created on the distal limbs and hindquarters of ponies and ...
Jørgensen E, Bay L, Bjarnsholt T, Bundgaard L, Sørensen MA, Jacobsen S.In humans, biofilm is a well-known cause of delayed healing and low-grade inflammation of chronic wounds. In horses, biofilm formation in wounds has been studied to a very limited degree. The objective of this study was thus to investigate the occurrence of biofilm in equine experimental wounds healing by secondary intention. Tissue biopsies from non-contaminated, experimental excisional shoulder and limb wounds were obtained on day 1-2, day 7-10 and day 14-15 post-wounding. Limb wounds were either un-bandaged or bandaged to induce exuberant granulation tissue (EGT) formation and thereby impai...
Sørensen MA, Petersen LJ, Bundgaard L, Toft N, Jacobsen S.As in other fibroproliferative disorders, hypoxia has been suggested to play a key role in the pathogenesis of exuberant granulation tissue (EGT). The purpose of this study was to investigate metabolism and blood flow locally in full-thickness wounds healing with (limb wounds) and without (body wounds) formation of EGT. Microdialysis was used to recover endogenous metabolites from the wounds, and laser Doppler flowmetry was used to measure blood flow. Measurements were performed before wounding and 1-28 days after wounding. Blood flow was consistently lower in limb wounds than in body wounds t...
Dart AJ, Perkins NR, Dart CM, Jeffcott LB, Canfield P.To evaluate the effect of a non-occlusive dressing incorporated in a 3-layer bandage on second intention healing of wounds of the distal portion of the limb. Methods: Untreated wounds in 33 adult horses used in four studies using the same wound-healing model conducted over 5 years. Methods: Standardised, full-thickness wounds were made in the skin overlying the dorsomedial aspect of the mid-metacarpus; 17 horses were bandaged with a non-occlusive dressing covered by gauze-coated cotton wool that was compressed with adhesive tape; 16 horses were left unbandaged. Wounds were photographed weekly ...
Spaas JH, Broeckx S, Van de Walle GR, Polettini M.Stem-cell therapy represents a promising strategy for the treatment of challenging pathologies, such as large, infected wounds that are unresponsive to conventional therapies. The present study describes the clinical application of peripheral blood stem cells (PBSCs) for the treatment of four adult Warmblood horses with naturally occurring wounds, which were unresponsive to conventional therapies for at least 3 months. A visual assessment was performed, and a number of wound-healing parameters (granulation tissue, crust formation and scar formation) were evaluated. In all cases, tissue overgro...
Yang G, Prestwich GD, Mann BK.The progression of wound healing is a complicated but well-known process involving many factors, yet there are few products on the market that enhance and accelerate wound healing. This is particularly problematic in veterinary medicine where multiple species must be treated and large animals heal slower, oftentimes with complicating factors such as the development of exuberant granulation tissue. In this study a crosslinked-hyaluronic-acid (HA-) based biomaterial was used to treat wounds on multiple species: rats, dogs, and horses. The base molecule, thiolated carboxymethyl HA, was first foun...
Dória RG, Freitas SH, Linardi RL, Mendonça Fde S, Arruda LP, Boabaid FM, Valadão CA.To evaluate the effects of intravenous regional limb perfusion (IRLP) administration of amphotericin B in horses to treat pythiosis after surgical excision and thermocautery. Methods: Case series. Methods: Horses (n = 12) with Pythium insidiosum infection of the distal aspect of the thoracic or pelvic limbs. Methods: After surgical excision of granulation tissue and thermocautery, 50 mg amphotericin B was administered by IRLP through a catheter placed in a superficial vein of the affected limb next to the lesion after placing a tourniquet above the injection site. The lesions and locomotor sys...
Van Hecke LL, Hermans K, Haspeslagh M, Chiers K, Pint E, Boyen F, Martens AM.The aim of this study was to evaluate different techniques for diagnosing wound infection in wounds healing by second intention in horses and to assess the effect of a vortex and sonication protocol on quantitative bacteriology in specimens with a histologically confirmed biofilm. In 50 wounds healing by second intention, a clinical assessment, a quantitative swab, a semi-quantitative swab, and a swab for cytology were compared to a quantitative tissue biopsy (reference standard). Part of the biopsy specimen was examined histologically for evidence of a biofilm. There was a significant, high c...
Schwartz AJ, Wilson DA, Keegan KG, Ganjam VK, Sun Y, Weber KT, Zhang J.To determine significant molecular and cellular factors responsible for differences in second-intention healing in thoracic and metacarpal wounds of horses. Methods: 6 adult mixed-breed horses. Methods: A full-thickness skin wound on the metacarpus and another such wound on the pectoral region were created, photographed, and measured, and tissue was harvested from these sites weekly for 4 weeks. Gene expression of type-I collagen, transforming growth factor (TGF)-beta1, matrix metalloproteinase (MMP)-1, and tissue inhibitor of metalloproteinase (TIMP)-1 were determined by quantitative in situ ...
Nomura M, Hosaka Y, Kasashima Y, Ueda H, Takehana K, Kuwano A, Arai K.The DNA microarray analysis for matrix metalloproteinase (MMP)-related mRNA expression in equine superficial digital flexor tendinitis indicated that mRNA level of MMP-13 was apparently up-regulated in the tendinitis as compared to normal tendon. In situ hybridization also revealed that fibroblastic cells proliferated in the granulation tissue generated in the tendinitis actively expressed MMP-13 mRNA. On the other hand, in normal tendon, a few fibroblastic cells and vascular components lied in the endotenon barely expressed its mRNA, but other cellular components in the tendon bundle were not...
