Exuberant Granulation Tissue

Theoret, Christine L.; Wilmink, Jacintha M.

doi:10.1002/9781118999219.ch15

Cited by 10 publications

(20 citation statements)

References 69 publications

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“…The probiotic treated wounds of CGB may have profited most by the reduction of the bacterial load as this also decreases the chronic inflammatory response inherently present in the later phases of the equine healing process [ 8 ]. Chronic inflammation inhibits wound contraction and delays healing [ 1 , 40 ].…”

Section: Discussionmentioning

confidence: 99%

The evaluation of the effect of probiotics on the healing of equine distal limb wounds

Wilmink

Ladefoged²,

Jongbloets³

et al. 2020

PLoS ONE

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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 in CGB and increased rapidly from day 0 until day 12 up to 30%, and stabilized around 25% thereafter until the end of the observation period, but it was not statistically significant because of the large variation within the treatment groups. The mean wound area of CGB decreased to 28.4% (range: 6.3 to 49.3) with probiotic and to 51.9% (range: 29.3 to 81.7) with saline treatment at day 24. Additionally, the rate to 50% healing in CGB was 3.4 faster with probiotic compared to saline treatment, whereas in ICGB this was 1.9 faster. Topical probiotics did not increase serum amyloid A and white blood cell counts. Although the mentioned differences were not statistically significant, the clinical relevance of the effect of treatment with probiotics in CGB wounds is clear, supported by the differences in mean wound area in course of time and the time required to reach 50% healing (day 12 for probiotic vs more than day 24 for saline treated wounds). Thus the probiotic treated wounds reached 50% reduction in wound area in half of the time of the saline treated wounds. The topical use of probiotics can be considered as safe as it did not cause a systemic effect.

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Section: Discussionmentioning

confidence: 99%

The evaluation of the effect of probiotics on the healing of equine distal limb wounds

Wilmink

Ladefoged²,

Jongbloets³

et al. 2020

PLoS ONE

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“…The low rate of remission presented in distal limb rests on the fact that the equine species has peculiarities such as chronic inflammation, exuberant development of granulation, slow epithelialization and inefficient contraction (THEORET; WILMINK, 2008). The healing difficulty in distal limb can also be attributed to anatomical and physiological characteristics of this region, which includes smaller blood supply, joint high mobility, higher level of contamination due to proximity to the ground and no muscle support (HENDRICKSON, 2005).…”

Section: Discussionmentioning

confidence: 99%

Equine pythiosis: Report of 28 cases from São Paulo State, Brazil

et al. 2015

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Pythiosis is a granulomatous lesion of the skin and subcutaneous tissues caused by Pythium insidiosum, a microorganism belonging to the Stramenopila Kingdom and the Oomycetes Class. The pathogen is commonly found in water environments, mainly in tropical areas of the world. Twenty eight cases of equine pythiosis were presented at the Large Animal Surgery Department of the School of Veterinary Medicine and Animal Science, São Paulo State University, Brazil in six years. Among the 28 animals, 13 presented distal lesions on the limbs, with four being immediately euthanized and seven dying due to loss of body condition leading to cachexia. The horses presented with one or more wounds in the body, distributed as follows: limbs (13 distal, four proximal), abdominal region (7), thoracic region (1), pectoral region (1), lumbar region (1), nasal region (1) and prepuce (1). The diagnosis was made by the association of the macroscopic aspects of the lesions with the histopathology, isolation of the pathogen and/or nested-PCR. Treatments included surgical removal of the lesion (16), potassium iodide 67 mg kg -1 PO sid (23), intravenous regional perfusion with 50 mg of amphotericin B (6) and immunotherapy (8). Pythiosis is a disease that develops quickly, but its diagnosis is time-consuming; therefore, establishing an early treatment with special attention to the involvement of distal regions of the limbs is important. Key words: Equine, granulomatous, pythiosis, Pythium insidiosum, surgery, wound ResumoA pitiose é uma doença granulomatosa do tecido cutâneo e subcutâneo causado pelo oomiceto Pythium insidiosum, microorganismo pertencente ao reino Stramenopila, classe Oomycetes. O agente é comumente encontrado em ambientes aquáticos, principalmente nas áreas tropicais do mundo. Foram atendidos 28 casos no Serviço de Clínica Cirúrgica de Grandes Animais da Faculdade de Medicina Veterinária e Zootecnia, UNESP, Botucatu, São Paulo, Brasil. Dentre os 28 animais, 13 apresentaram lesões distais de membro, sendo quatro imediatamente submetidos à eutanásia e sete morreram devido à perda progressiva de condição corporal levando a caquexia. Os equinos apresentaram uma ou mais lesões, distribuídas da seguinte forma: membros (13 distais e quatro proximais), região abdominal (7), região torácica (1), região peitoral (1), região lombar (1), região nasal (1), prepúcio (1). O diagnóstico foi baseado na associação dos achados macroscópicos, histopatológicos, isolamento do patógeno e/ou nested-PCR. Os tratamentos incluíram: remoção cirúrgica (16), iodeto de potássio 67 mg kg -1 VO Sid (23), perfusão regional com 50 mg de anfotericina B (6) e imunoterapia (8 de rápido desenvolvimento, sendo imprescindível o diagnóstico rápido com especial atenção às lesões localizadas na região distal do membro.

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“…Traumatic cutaneous limb wounds occur frequently in horses and often develop complications [ 1 ]. Compared with wounds on the body, limb wounds have a prolonged lag phase [ 2 , 3 , 4 ] where the wound edges retract and the wound initially becomes larger and then decreases back to the original size.…”

Section: Introductionmentioning

confidence: 99%

Macroscopic, Histologic, and Immunomodulatory Response of Limb Wounds Following Intravenous Allogeneic Cord Blood-Derived Multipotent Mesenchymal Stromal Cell Therapy in Horses

Mund

MacPhee

Campbell

et al. 2021

Cells

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Limb wounds are common in horses and often develop complications. Intravenous multipotent mesenchymal stromal cell (MSC) therapy is promising but has risks associated with intravenous administration and unknown potential to improve cutaneous wound healing. The objectives were to determine the clinical safety of administering large numbers of allogeneic cord blood-derived MSCs intravenously, and if therapy causes clinically adverse reactions, accelerates wound closure, improves histologic healing, and alters mRNA expression of common wound cytokines. Wounds were created on the metacarpus of 12 horses. Treatment horses were administered 1.51–2.46 × 108 cells suspended in 50% HypoThermosol FRS, and control horses were administered 50% HypoThermosol FRS alone. Epithelialization, contraction, and wound closure rates were determined using planimetric analysis. Wounds were biopsied and evaluated for histologic healing characteristics and cytokine mRNA expression. Days until wound closure was also determined. The results indicate that 3/6 of treatment horses and 1/6 of control horses experienced minor transient reactions. Treatment did not accelerate wound closure or improve histologic healing. Treatment decreased wound size and decreased all measured cytokines except transforming growth factor-β3. MSC intravenous therapy has the potential to decrease limb wound size; however, further work is needed to understand the clinical relevance of adverse reactions.

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Exuberant Granulation Tissue

Cited by 10 publications

References 69 publications

The evaluation of the effect of probiotics on the healing of equine distal limb wounds

The evaluation of the effect of probiotics on the healing of equine distal limb wounds

Equine pythiosis: Report of 28 cases from São Paulo State, Brazil

Macroscopic, Histologic, and Immunomodulatory Response of Limb Wounds Following Intravenous Allogeneic Cord Blood-Derived Multipotent Mesenchymal Stromal Cell Therapy in Horses

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