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Topic:Granulation Tissue

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.
Equine exuberant granulation tissue and human keloids: a comparative histopathologic study.
Veterinary surgery : VS    September 9, 2013   Volume 42, Issue 7 783-789 doi: 10.1111/j.1532-950X.2013.12055.x
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...
The effects of equine peripheral blood stem cells on cutaneous wound healing: a clinical evaluation in four horses.
Clinical and experimental dermatology    March 23, 2013   Volume 38, Issue 3 280-284 doi: 10.1111/ced.12068
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...
Aberrant wound healing in the horse: naturally occurring conditions reminiscent of those observed in man. 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...
Effect of unfocused extracorporeal shock wave therapy on growth factor gene expression in wounds and intact skin of horses.
American journal of veterinary research    February 1, 2013   Volume 74, Issue 2 324-332 doi: 10.2460/ajvr.74.2.324
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...
Active hyaluronidase 2 expression in the granulation tissue formed in the healing process of equine superficial digital flexor tendonitis.
The Journal of veterinary medical science    October 5, 2012   Volume 75, Issue 2 219-223 doi: 10.1292/jvms.12-0318
Yuda Y, Kasashima Y, Kuwano A, Sato K, Hattori S, Arai K.Upregulation of hyaluronidase 2 (HYAL2), one of somatic hyaluronidase (HAase), was demonstrated in granulation tissue during the healing of equine superficial digital flexor tendon injuries. The activity of HAase was assessed by hyaluronan (HA)-containing gel zymography and in situ zymography using frozen sections obtained from normal and injured tendon tissues. Elevated HAase activity was identified in the extract from the tendinopathic tissues, with lower levels of the activity in normal tendons. In situ zymography using fluorescently-labeled HA demonstrated HAase activity in the granulation...
Treatment of pythiosis in equine limbs using intravenous regional perfusion of amphotericin B.
Veterinary surgery : VS    July 27, 2012   Volume 41, Issue 6 759-765 doi: 10.1111/j.1532-950X.2012.01019.x
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...
A preliminary study of diagnostic color Doppler ultrasonography in equine superficial digital flexor tendonitis.
The Journal of veterinary medical science    July 13, 2012   Volume 74, Issue 12 1639-1642 doi: 10.1292/jvms.12-0177
Murata D, Misumi K, Fujiki M.We hypothesized that semi-quantitative determinations of changeable blood flows in granulation and scar tissues during tendon healing could be helpful for differentiation between the acute phase rich in blood vessels and the remodeling phase with fewer vessels. Ten Thoroughbreds with injured superficial digital flexor tendon (SDFT) in a forelimb were used for evaluation of blood flows in the injured tendons of racehorses using color Doppler (CD) ultrasonography. Using longitudinal CD images, features of maximum color activities were defined. These were rhythmically blinking, tiny to small sign...
Skin temperature during cutaneous wound healing in an equine model of cutaneous fibroproliferative disorder: kinetics and anatomic-site differences.
Veterinary surgery : VS    June 29, 2012   Volume 42, Issue 2 147-153 doi: 10.1111/j.1532-950X.2012.00966.x
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...
Evaluation of a laryngotomy approach for near-total resection of the nasal septum in the horse.
Veterinary surgery : VS    April 30, 2012   Volume 41, Issue 5 643-648 doi: 10.1111/j.1532-950X.2012.00974.x
Loinaz RJ, Boutros CP, Rakestraw PC, Taylor TS.To report a laryngotomy approach for the removal of the nasal septum in adult horses. Methods: Descriptive study. Methods: Horses (n = 10). Methods: Near-total resection of the nasal septum was made using a modification of a previously reported 3-wire technique using a trephination approach and a 2-wire technique using a laryngotomy approach. Surgical time, ease of technique, complications, and outcome were recorded. At 45 days, horses were euthanatized and septal measurements made. Results: Near-total resection of the nasal septum was accomplished with both techniques without complications. I...
Clinicopathologic observations on laryngoplasty failure in a horse.
Veterinary surgery : VS    April 30, 2012   Volume 41, Issue 5 649-653 doi: 10.1111/j.1532-950X.2012.00975.x
Hardcastle MR, Pauwels FE, Collett MG.To report morphologic findings associated with laryngoplasty failure in a horse. Methods: Clinical report. Methods: A 9-year-old Thoroughbred cross gelding. Methods: Necropsy and histopathology were performed on a horse that died peracutely during anesthetic recovery after correction of a right dorsal displacement of the ascending colon. Three weeks earlier the horse had left laryngoplasty and ventriculocordectomy. Results: Dissection of the larynx revealed that the laryngoplasty suture had pulled through the muscular process of the left arytenoid cartilage, which appeared grossly normal. Hist...
Thiolated carboxymethyl-hyaluronic-Acid-based biomaterials enhance wound healing in rats, dogs, and horses.
ISRN veterinary science    January 11, 2012   Volume 2011 851593 doi: 10.5402/2011/851593
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...
Heterobilharzia americana infection as a cause of hepatic parasitic granulomas in a horse.
Journal of the American Veterinary Medical Association    October 12, 2011   Volume 239, Issue 8 1117-1122 doi: 10.2460/javma.239.8.1117
Corapi WV, Birch SM, Carlson KL, Chaffin MK, Snowden KF.CASE DESCRIPTION-A 22-year-old American Paint Horse gelding from the Gulf Coast region of Texas was evaluated for regrowth of a perirectal squamous cell carcinoma that had been surgically removed 11 months previously. CLINICAL FINDINGS-A necrotic and ulcerated mass was present below the anus. The horse had paraphimosis and was having difficulty with urination. Histologic examination of the mass revealed that it was squamous cell carcinoma, and the horse was euthanized because of the unlikelihood that the mass could be adequately resected and its close proximity to the urethra. OUTCOME-At necro...
A comparative study of the histopathology and immunohistochemistry of pythiosis in horses, dogs and cattle.
Journal of comparative pathology    August 6, 2011   Volume 146, Issue 2-3 122-131 doi: 10.1016/j.jcpa.2011.06.006
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....
Computed tomography or magnetic resonance imaging-assisted partial hoof wall resection for keratoma removal.
Veterinary surgery : VS    July 19, 2011   Volume 40, Issue 6 708-714 doi: 10.1111/j.1532-950X.2011.00864.x
Getman LM, Davidson EJ, Ross MW, Leitch M, Richardson DW.To (1) describe the computed tomography (CT) and magnetic resonance imaging (MRI) appearance of keratomas; (2) describe a CT- or MRI-assisted partial hoof wall resection technique for removal of keratomas; and (3) evaluate the morbidity and postoperative outcome of these horses. Methods: Case series. Methods: Horses (n=10) with keratoma. Methods: Data retrieved from medical records included signalment, lameness duration and grade, physical and diagnostic evaluation findings, CT and MRI technique and findings, surgical details, histopathologic diagnosis, postoperative treatment, and complicatio...
Effects of unfocused extracorporeal shock wave therapy on healing of wounds of the distal portion of the forelimb in horses.
American journal of veterinary research    February 2, 2010   Volume 71, Issue 2 229-234 doi: 10.2460/ajvr.71.2.229
Silveira A, Koenig JB, Arroyo LG, Trout D, Moens NM, LaMarre J, Brooks A.To determine effects of extracorporeal shock wave therapy (ESWT) on healing of wounds in the distal portion of the forelimb in horses. Methods: 6 horses. Methods: Five 6.25-cm2 superficial wounds were created over both third metacarpi of 6 horses. Forelimbs were randomly assigned to treatment (ESWT and bandage) or control (bandage only) groups. In treated limbs, each wound was treated with 625 shock wave pulses from an unfocused electrohydraulic shock wave generator. In control limbs, each wound received sham treatment. Wound appearance was recorded weekly as inflamed or healthy and scored for...
Effect of bandaging on second intention healing of wounds of the distal limb in horses.
Australian veterinary journal    June 6, 2009   Volume 87, Issue 6 215-218 doi: 10.1111/j.1751-0813.2009.00428.x
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 ...
Equine thrombospondin II and secreted protein acidic and cysteine-rich in a model of normal and pathological wound repair.
Physiological genomics    April 28, 2009   Volume 38, Issue 2 149-157 doi: 10.1152/physiolgenomics.90383.2008
Miragliotta V, Raphaël K, Ipiña Z, Lussier JG, Theoret CL.Wound healing in horses is complicated, particularly when wounds are on the limb. The objectives of this study were to clone equine thrombospondin II (THBS2) and secreted protein acidic and cysteine-rich (SPARC) cDNAs and to compare the spatiotemporal expression of mRNAs and proteins during repair of body and limb wounds. These molecules were targeted in view of their potential biological contribution to angiogenesis, which is exacerbated during the repair of limb wounds in horses. Cloning was achieved by screening size-selected cDNA libraries previously derived from 7-day-old wounds. Expressi...
Effects of platelet-rich plasma on the repair of wounds on the distal aspect of the forelimb in horses.
American journal of veterinary research    February 24, 2009   Volume 70, Issue 2 277-282 doi: 10.2460/ajvr.70.2.277
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...
Complications of equine wound management and dermatologic surgery.
The Veterinary clinics of North America. Equine practice    February 11, 2009   Volume 24, Issue 3 663-ix doi: 10.1016/j.cveq.2008.10.005
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...
OB-cadherin cloning and expression in a model of wound repair in horses.
Equine veterinary journal    January 24, 2009   Volume 40, Issue 7 643-648 doi: 10.2746/042516408x322148
Miragliotta V, Lefebvre-Lavoie J, Lussier JG, Theoret CL.Horses suffer from a debilitating impediment in repairing wounds located on the lower limb that leads to the development of a fibroproliferative disorder (exuberant granulation tissue). This condition is a source of wastage since it often forces retirement from competition. Treatments that resolve or prevent this condition are still lacking, maybe due to deficient knowledge of the underlying molecular mechanisms. Fibroblast-to-myofibroblast conversion is an essential step allowing contraction during wound repair and is accompanied by an increase in OB-cadherin expression. Objective: To clone e...
Laminin receptor 1 is differentially expressed in thoracic and limb wounds in the horse.
Veterinary dermatology    December 12, 2008   Volume 20, Issue 1 27-34 doi: 10.1111/j.1365-3164.2008.00718.x
Miragliotta V, Lussier JG, Theoret CL.Healing of wounds located on the distal limbs of horses is often complicated by retarded epithelialization and the development of exuberant granulation tissue (proud flesh). Treatments that definitively resolve this pathological process are still unavailable. Molecular studies of the repair mechanism might contribute to the development of new therapeutic strategies. The study presented herein aimed to clone the full length cDNA and to study the spatio-temporal expression profile of mRNA and protein for LAMR1, previously attributed a role in wound epithelialization, during the repair of body an...
Equine ANXA2 and MMP1 expression analyses in an experimental model of normal and pathological wound repair.
Journal of dermatological science    April 22, 2008   Volume 51, Issue 2 103-112 doi: 10.1016/j.jdermsci.2008.03.008
Miragliotta V, Lefebvre-Lavoie J, Lussier JG, Theoret CL.Wounds on horse limbs can develop exuberant granulation tissue which resembles the human keloid. Clues gained from the study of over-scarring in horses might help control fibro-proliferative disorders. Objective: The aim of the present study was to clone full-length equine ANXA2 cDNA then to study spatio-temporal expression of ANXA2 and MMP1 mRNA and protein, potential contributors to remodeling, during repair of body (normal) and limb (fibro-proliferative) wounds in an established horse wound model. Methods: Cloning of ANXA2 was achieved by screening size-selected cDNA libraries. Expression w...
Long-term study of partial arytenoidectomy with primary mucosal closure in 76 Thoroughbred racehorses (1992-2006).
Equine veterinary journal    February 13, 2008   Volume 40, Issue 3 214-218 doi: 10.2746/042516408X273666
Parente EJ, Tulleners EP, Southwood LL.The effectiveness and best method to perform a partial arytenoidectomy in racehorses is unclear. This study was performed to evaluate the success of and complications that can occur after a unilateral partial arytenoidectomy with primary mucosal closure in Thoroughbred racehorses. Objective: Partial arytenoidectomy is an effective surgical procedure to return Thoroughbred racehorses, afflicted by arytenoid chondropathy or a failed laryngoplasty, to preoperative levels of performance. Methods: Seventy-six Thoroughbred racehorses admitted to the New Bolton Centre between 1992 and 2006 were asses...
Effects of hyperbaric oxygen on full-thickness meshed sheet skin grafts applied to fresh and granulating wounds in horses.
American journal of veterinary research    January 3, 2008   Volume 69, Issue 1 144-147 doi: 10.2460/ajvr.69.1.144
Holder TE, Schumacher J, Donnell RL, Rohrbach BW, Adair HS.To determine the effects of hyperbaric oxygen therapy (HBOT) on full-thickness skin grafts applied to fresh and granulating wounds of horses. Methods: 6 horses. Methods: On day 0, two 4-cm-diameter circular sections of full-thickness skin were removed from each of 2 randomly selected limbs of each horse, and two 4-cm-diameter circular skin grafts were harvested from the pectoral region. A skin graft was applied to 1 randomly selected wound on each limb, leaving the 2 nongrafted wounds to heal by second intention. On day 7, 2 grafts were harvested from the pectoral region and applied to the gra...
Active expression of matrix metalloproteinase-13 mRNA in the granulation tissue of equine superficial digital flexor tendinitis.
The Journal of veterinary medical science    July 6, 2007   Volume 69, Issue 6 637-639 doi: 10.1292/jvms.69.637
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...
Endothelial cell hypertrophy is associated with microvascular occlusion in horse wounds. Dubuc V, Lepault E, Theoret CL.Wound repair in horse limbs is often complicated by excessive fibroplasia and scarring. Occlusion of the microvessels populating the granulation tissue appears to be involved in the excessive accumulation of extracellular matrix during the repair of limb wounds. This study aimed to determine whether endothelial cell hypertrophy or hyperplasia, or both, contribute to microvascular occlusion and whether the pericyte is involved in this anomaly. We created 5 wounds, each 2.5 x 2.5 cm, on both forelimbs and on the body of 6 horses. One limb was bandaged to stimulate excessive wound fibroplasia. We...
Surgical correction of ear curling caused by scar tissue formation in a horse.
Journal of the American Veterinary Medical Association    October 14, 2005   Volume 227, Issue 7 1130-1090 doi: 10.2460/javma.2005.227.1130
Massoni S, Vlaminck LE, Cokelaere SM, Martens AM.An 18-month-old Belgian Warmblood mare was evaluated because it had injured the outer convex aspect of the left auricle. Second intention healing of the wound area caused tissue contracture, which resulted in the tip of the ear curling backward. By use of a technique involving undermining of the skin and a flap of granulation tissue on the medial aspect of the wound area and multiple incisions of the auricular cartilage, the curling was relieved and the ear regained a more normal shape. A skin graft was applied to cover the existing wound defect in an attempt to accelerate wound healing; therm...
Comparative study on microvascular occlusion and apoptosis in body and limb wounds in the horse.
Wound repair and regeneration : official publication of the Wound Healing Society [and] the European Tissue Repair Society    September 24, 2005   Volume 13, Issue 5 520-529 doi: 10.1111/j.1067-1927.2005.00073.x
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...
Effect of a silicone-containing dressing on exuberant granulation tissue formation and wound repair in horses.
American journal of veterinary research    August 23, 2005   Volume 66, Issue 7 1133-1139 doi: 10.2460/ajvr.2005.66.1133
Ducharme-Desjarlais M, Céleste CJ, Lepault E, Theoret CL.To determine the effect of a silicone dressing on the rate and quality of repair of limb wounds and compare microvascular occlusion and apoptosis in wounds treated with the silicone dressing and those treated with a conventional dressing in horses. Methods: 5 horses. Methods: Horses received two 6.25-cm2 wounds on each metacarpus. Ten wounds were treated with a silicone dressing; the other 10 were treated with a control dressing. Quality of repair and wound size were evaluated at each bandage change. Time to healing and the number of excisions of exuberant granulation tissue were recorded. Bio...
Second-intention repair in the horse and pony and management of exuberant granulation tissue.
The Veterinary clinics of North America. Equine practice    February 5, 2005   Volume 21, Issue 1 15-32 doi: 10.1016/j.cveq.2004.11.014
Wilmink JM, van Weeren PR.Second-intention repair is faster in ponies than in horses and faster in body wounds than in limb wounds. To a large extent, the differences between horses and ponies can be explained by differences in the local inflammatory response, which are a result of the functional capacity of leukocytes. In ponies, leukocytes produce more inflammatory mediators,resulting in better local defense, faster cellular debridement, and a faster transition to the repair phases, with more wound contraction. In horses,leukocytes produce fewer mediators, initiating a weak inflammatory response, which becomes chroni...