Surgical Management of Exuberant Granulation Tissue in Equines: A Study of Eight Cases

Sandeep Saharan; Prem Singh; R. P. Gupta; Ajit Singh; Ravi Dutt

Authors

Sandeep Saharan Department of Veterinary Clinical Complex, Lala Lajpat Rai University of Veterinary & Animal Sciences, Hisar-125004, INDIA
Prem Singh Department of Veterinary Surgery and Radiology, Lala Lajpat Rai University of Veterinary & Animal Sciences, Hisar-125004, INDIA
R. P. Gupta Department of Veterinary Pathology, Lala Lajpat Rai University of Veterinary & Animal Sciences, Hisar-125004, INDIA
Ajit Singh Department of Veterinary Microbiology, Lala Lajpat Rai University of Veterinary & Animal Sciences, Hisar-125004, INDIA
Ravi Dutt Department of Veterinary Gynaecology and Obstetrics, Lala Lajpat Rai University of Veterinary and Animal Sciences, Hisar INDIA

Keywords:

Equine, Granulation Tissue, Histopathology, Proud Flesh

Abstract

Exuberant granulation tissue, commonly known as proud flesh/ fibroplasia, is a frustrating complication of wound healing and is mostly seen in the equines. The study was conducted on eight (six males and two females) clinical cases of exuberant granulation tissue (EGT) in equines brought to Veterinary Clinical Complex (VCC). Lesions were 15 days to 6 months old in these cases. Being more prone to injury, the limbs were affected in five cases. Surgical resection of this EGT was carried out in all the cases and the biopsy samples were taken. Histopathologically, granulation tissue was characterized by the proliferation of fibrous tissue along with blood vessels and inflammatory cells. Homecare was done with the help of antibiotics, analgesics, Vitamin-B Complex, and Vit. C. All the cases recovered after 2-3 weeks of the treatment without any complications.

References

Basha KMA, Shah MA, Khan S and Amarpal (2019). Surgical management of proud flesh-a report of two equines. Intas Polivet.20(2):307-309.

Bertone AL (1989). Management of exuberant granulation tissue. Vet. Clinic. North Am: Equine Pract.5: 551-562.

Celeste CJ, Deschene K, Riley CB and Theoret CL (2011). Regional differences in wound oxygenation during normal healing in an equine model of cutaneous fibroproliferative disorder. Wound Repair Regen.19(1): 89 97.

Cochrane CA, Pain R and Knottenbelt DC (2003). In-vitro wound contraction in the horse: Differences between body and limb wounds. Wounds in Pract.15: 175-81.

Deschene K, Céleste C, Boerboom D and Theoret CL (2012). Hypoxia regulates the expression of extracellular matrix associated proteins in equine dermal fibroblasts via HIF1. J. Dermatol. Sci.65 (1): 12 18.

Dubey P, Bansal V, Mowar A, Bansal R, Gupta M and Rajput A (2020). Proud flesh: a complicated wound healing-case report and review of literature. J. Maxillofac. Oral Surg. DOI 10.1007/s12663-020-01344-9.

Eesa M and Bader O (2011). Treatment of hyper-granulated limb wounds in horses. Iraqi J. Vet. Sci.25(2): 71-80.

Lepault E, Céleste C, Doré M, Martineau D and Theoret CL (2005). Comparative study on microvascular occlusion and apoptosis in body and limb wounds in the horse. Wound Repair Regen.13(5): 520 529.

Linares HA (1996). From wound to scar. Burns.22(5):339–352

Luna LG (1968). Manual of histologic staining methods of armed forces institute of pathology (3rd Edn). McGraw Hill, New York, USA.

McGrath BM and Gary W(2005). Directory of therapeutic enzymes, Taylor and Francis, New York. p 282.

Miller CB, Wilson DA, Keegan KG, Kreeger JM, Adelstein EH and Ganjam VK (2000). Growth characteristics of fibroblasts isolated from the trunk and distal aspect of the limb of horses and ponies. Vet. Surg. 29: 1–7.

Mondal P, Majie A K and Sen C. (2016). Proud flesh management in horse: A case report. Explor. Anim. Med. Res.6(2):258-260.

Shivaraju S, Maiti SK, Kalaiselvan E, Prakash GV, Divya M, Aswathy G and Kumar SSP(2021). Successful management of exuberant granulation tissue in two horses (Equus caballus) and a donkey (Equus asinus). Large Anim. Review.27: 367-369.

Theoret CL and Wilmink JM (2008). Treatment of exuberant granulation tissue. In: Equine wound management (T.S. Stashack and C.L. Theoret, eds). Wiley Blackwell, Ames, Iowa, USA, 445 462.

Varasano V, Marruchella G and Petrizzi L (2018). Exuberant granulation tissue in a horse: successful treatment by the intralesional injection of 4% formaldehyde solution. Veterinar. Italiana. 54 (2): 155-159.

Vegad JL (2001). Healing. In: Veterinary pathology by Shastry, G.A. and Rao, P.R. 7th Edn., CBS Publications, New Delhi, p. 70.

Wilmink JM and Weeren PRV (2004). Treatment of exuberant granulation tissue. Clinical Tech. Equine Pract.3: 141-47.

Xue M and Jackson CJ (2015). Extracellular matrix reorganization during wound healing and its impact on abnormal scarring. Adv. Wound Care.4: 119–136.