The granulation (t)issue: A narrative and scoping review of basic and clinical research of the equine distal limb exuberant wound healing disorder.
Abstract: 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 knowledge gaps and opportunities for future research, a search was systematically conducted using predefined search terms. Subsequently, a scoping review was conducted using specific criteria to select the peer-reviewed literature that described methods to treat and/or prevent EGT. Proposed mechanisms of effects as well as results and main conclusions were extracted and tabulated. The systematic search resulted in 1062 publications in PubMed and 767 in Web of Science. Twenty additional studies were later included. Of these, 327 studies were reviewed for the narrative review on basic research and 35 controlled clinical trials were eligible for the scoping review. All 35 studies were conducted in university hospitals, and all but one involved surgically induced non-infected wounds. The study population was predominantly horses (n = 230) with a small number of ponies (n = 18) and donkeys (n = 14). In conclusion, there remains a strong need for evidence-based recommendations on EGT treatment, preferably using multi-centre studies that represent the general population of horses, include higher numbers of animals, and are performed in naturally occurring wounds. This narrative and scoping review also emphasises the importance of incorporating basic research knowledge in the study design of clinical trials.
Copyright © 2022 Elsevier Ltd. All rights reserved.
Publication Date: 2022-01-31 PubMed ID: 35093532DOI: 10.1016/j.tvjl.2022.105790Google Scholar: Lookup
The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
- Journal Article
- Scoping Review
Summary
This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.
The research article presents a scoping review and narrative analysis of past research on Exuberant Granulation Tissue (EGT), a complication that frequently emerges during second intention wound healing in horses. The authors examined the studies to understand potential prevention and treatment strategies, identify knowledge gaps, and suggest future research avenues.
Understanding Exuberant Granulation Tissue (EGT)
- EGT is a condition that commonly appears during the wound healing process of horses, specifically second intention wound healing.
- The cause of EGT is multifaceted, involving several factors such as hyperactive fibroblasts, malfunctioning keratinocyte differentiation, inadequate wound contraction, dysfunctional vascularization, and chronic inflammation.
- Due to these complexities, the development of EGT is poorly understood, and effective techniques to prevent or manage it are yet to be determined.
Methodology: Systematic Search and Scoping Review
- The researchers used predefined search terms to investigate the literature related to EGT.
- The search resulted in 1,062 results from PubMed and 767 from Web of Science. Twenty additional studies were added to the collection later.
- Eventually, 327 studies were selected for a narrative review based on basic research, and 35 controlled clinical trials were chosen for the scoping review.
- The criteria for inclusion in the review were strictly defined, ensuring relevant papers that could add meaningful value to the study were reviewed.
Research Settings and Participants
- All 35 studies used in the scoping review were conducted in university hospitals, and they predominantly involved surgically induced non-infected wounds.
- The main participants of these studies were horses, with a total number of 230. A few ponies (18) and donkeys (14) were also included.
Conclusion and Future Recommendations
- The study concludes that there is still a substantial void in evidence-based recommendations on treating EGT.
- The authors encourage future multi-centre studies for a more comprehensive and representative body of research. They also hold that there is a need for studies that involve a larger number of animals and naturally-occurring wounds.
- The authors also stress the need for integrating the knowledge from basic research when designing clinical trials, asserting the indispensable value of this type of research in understanding EGT.
Cite This Article
APA
Anantama NA, Du Cheyne C, Martens A, Roth SP, Burk J, De Spiegelaere W, Michler JK.
(2022).
The granulation (t)issue: A narrative and scoping review of basic and clinical research of the equine distal limb exuberant wound healing disorder.
Vet J, 280, 105790.
https://doi.org/10.1016/j.tvjl.2022.105790 Publication
Researcher Affiliations
- Institute of Veterinary Anatomy, Histology and Embryology, Leipzig University, An den Tierkliniken 43, 04103 Leipzig, Germany.
- Laboratory of Morphology, Ghent University, Salisburylaan 133, B-9820 Merelbeke, Belgium.
- Department of Surgery and Anaesthesiology of Domestic Animals, Ghent University, Salisburylaan 133, B-9820 Merelbeke, Belgium.
- Veterinary Teaching Hospital, Department for Horses, Leipzig University, An den Tierkliniken 21, 04103 Leipzig, Germany.
- Equine Clinic (Surgery, Orthopedics), Giessen University, Frankfurter Str. 108, 35392 Gießen, Germany.
- Laboratory of Morphology, Ghent University, Salisburylaan 133, B-9820 Merelbeke, Belgium.
- Institute of Veterinary Anatomy, Histology and Embryology, Leipzig University, An den Tierkliniken 43, 04103 Leipzig, Germany. Electronic address: jule.michler@vetmed.uni-leipzig.de.
MeSH Terms
- Animals
- Extremities
- Granulation Tissue
- Horse Diseases / therapy
- Horses
- Inflammation / veterinary
- Wound Healing
Citations
This article has been cited 5 times.- Partusch L, Rutland CS, Martens A, Du Cheyne C, De Spiegelaere W, Michler JK. Collagen composition in equine exuberant granulation tissue reflects tissue immaturity. PLoS One 2025;20(11):e0335179.
- Vicetti Miguel RD, Liu M, Campion GJ, Cherpes TL. Hypothesis: Ephrin-Eph Signaling Pathways Provide Novel Targets for Accelerated Re-Epithelialization of Cutaneous Wounds. Bioessays 2026 Jan;48(1):e70088.
- Zambroni ME, Bertone PA, Cabral AL, Boatti AS, Romanini SV, Martínez SR, Gómez ML. Easy-to-Apply Hydrogel Patch for Field Treatment and Monitoring of Equine Wounds. Gels 2025 Apr 27;11(5).
- Ribeiro G, Carvalho L, Borges J, Prazeres J. The Best Protocol to Treat Equine Skin Wounds by Second Intention Healing: A Scoping Review of the Literature. Animals (Basel) 2024 May 18;14(10).
- Maldonado-Cabrera B, Sánchez-Machado DI, López-Cervantes J, Osuna-Chávez RF, Ibarra-Zazueta C, Robles-Zepeda RE. Efficacy of chitosan in the treatment of chronic skin lesions in a horse: A case report. Vet Anim Sci 2022 Sep;17:100261.
Use Nutrition Calculator
Check if your horse's diet meets their nutrition requirements with our easy-to-use tool Check your horse's diet with our easy-to-use tool
Talk to a Nutritionist
Discuss your horse's feeding plan with our experts over a free phone consultation Discuss your horse's diet over a phone consultation
Submit Diet Evaluation
Get a customized feeding plan for your horse formulated by our equine nutritionists Get a custom feeding plan formulated by our nutritionists
