The granulation (t)issue: A narrative and scoping review of basic and clinical research of the equine distal limb exuberant wound healing disorder.

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.