Treatment of exuberant granulation tissue

Abstract

The formation of exuberant granulation tissue almost inevitably occurs during second-intention healing of limb wounds in horses. It can be described as an aberrant prolongation of the phase of granulation tissue formation, rather than the wound making a transition to contraction. The formation of exuberant granulation tissue is affected by several factors such as bandages, casts, chronic inflammation, wound location and motion, tissues involved, breed and iatrogenic factors. Uncommonly a neoplastic transformation may occur. Among all the factors, the presence of chronic inflammation may be the most important and often not recognized cause for exuberant granulation tissue. Treatment depends on the age of the exuberant granulation tissue and the cause. The cause should be identified and treated. Many agents have been used to treat or prevent exuberant granulation tissue; however, caustic agents or cryogenic surgery should not be used, because they prolong chronic inflammation and cause more proliferation. In general, the best therapy is surgical excision of the protruding tissue and several excisions may be required. When the chronic inflammation subsides, the wound will resume healing by contraction and epithelialization.