Treatment Of Granulation Tissue Research Articles

The Role of Bronchoscopic Cryoablation in Management of Central Airway Obstruction

Central airway obstruction is one of respiratory emergency manifested as dyspnea, stridor and obstructive pneumonia. Most of central airway obstruction cases were treated with resection and surgery. Bronchoscopy is an initial modality to diagnose, stabilize the airway obstruction and evaluate for palliative treatment. Cryoablation is an evolving therapeutic bronchoscopic methods. Through rapid freeze–thaw cycles, cryoablation causes cell death and tissue necrosis or tissue adherence that can be used via the flexible or rigid bronchoscope. Cryoablation can safely restore airway patency and improve symptoms in patients with central airways obstruction from exophytic tumours. It is also used in the treatment of granulation tissue and benign strictures. Clinical studies showed improvement of dyspnea, cough, and hemoptysis with non-significant complications.

1390 Impacted Fully Covered Self-Expanding Metal Biliary Stent Within an Uncovered Metal Stent by Exuberant Granulation Tissue Growth Successfully Removed After Treatment With Argon Plasma Coagulation (APC)

INTRODUCTION: We describe the case of an impacted, fully covered, self-expanding metal biliary stent within an uncovered metal stent because of exuberant granulation tissue growth at the ampullary orifice. The stent was successfully removed after treatment of granulation tissue with Argon Plasma Coagulation (APC). CASE DESCRIPTION/METHODS: A 95-year-old lady underwent placement of an uncovered self-expanding metal stent for a tight stricture of the distal bile duct by another gastroenterologist several years ago. The stricture was initially felt to be a malignant stricture but subsequently turned out to be a benign stricture. However, the biliary tree was frequently obstructed with excessive tissue ingrowth and recurrent stone formation requiring placement of a fully-covered self expanding metal stent within the uncovered metal stent, exchanged every nine months. During one of the ERCPs for stent exchange, the covered metal stent could not be removed because of exuberant growth of granulation tissue around the ampullary orifice covering the edges of the stent. The stent was left in place, the stones were extracted with a stone-extraction balloon and the granulation tissue was treated with APC. The plan was to bring the patient back for an ERCP and stent exchange after resolution of the granulation tissue. The patient ended up being hospitalized with stent occlusion and cholangitis after three months. At that time an ERCP was performed and the granulation tissue was noted to have completely resolved. The stent was occluded with stones and debris. The stent was removed without difficulty and a new stent was placed. The same exact situation recurred two years later. The granulation tissue was treated again with APC and stent was cleaned out with a stone-extraction balloon. The patient was brought back in three months for an ERCP and easy stent removal. DISCUSSION: Fully covered self-expanding metal stents have been used successfully for a variety of malignant and benign conditions and are generally easily removable. Occasionally exuberant growth of granulation tissue at the biliary orifice can preclude stent removal. Attempts to remove the stent forcibly can result in stent disruption and can lead to serious complications. In these situations the best approach is to treat the granulation tissue with APC and bring the patient back after resolution of the granulation tissue for an easy stent exchange.

Use of triamcinolone as treatment of granulation tissue (Proud flesh) in horses: case report

The occurrence of wounds and traumas in horses is relatively frequent of those animals. Because of having a great reserve of energy, combined with the agility and the instinct to run or fight, besides other factors, those animals are more predisposed to the occurrence of wounds. The management of wounds in horses is relatively delicate, since complications are not uncommon, and it can delay the treatment, as well as raise costs and require special care. Some points should be observed when handling wounds in horses, such as complete epithelialization without scar formation; shorter treatment time; avoid recurrence or complications that prolong the treatment, reduce costs. Exuberant granulation tissue is a common complication that occurs during the management of wounds in horses, and may be caused by prolonged treatment, wounds in regions with more moviments, infections, among other factors. Currently, there are several forms of treatment of exuberant granulation tissue in horses.The objective of this study was to report the success of the topical use of triamcinolone in three horses that presented exuberant granulation tissue growth. The horses presented exuberant granulation tissue growth in the distal region of the thoracic limb after trauma that generated the lesion. Treatment with 1mg triamcinolone ointment was started as an attempt to control and reduce the granulation tissue and allow the wound to heal completely and it was effective in all three treated cases, since the granulation tissue was reduced and the wound healed without major scars or any other damage to the horse.

Topical application of mitomycin C in the treatment of granulation tissue after canal wall down mastoidectomy.

Otorrhea and granulation tissue in Canal Wall Down mastoidectomy (CWD) is the common problem in cholesteatoma removal and leads to many discomfort for both the patient and the physician. The main objective in CWD is creating the dry cavity, so the topical antibiotic and acetic acid in variable saturations are used for this purpose. In this study we evaluate the effectiveness of topical MMC and chemical cautery by acetic acid. Study population consists of 50 patients with cholesteatoma whom underwent CWD. All patient allocated randomly in two study groups, MMC and acetic acid. After 3 weeks, the first visit is planned, extension of granulation tissue and dryness of cavity are evaluated and topical drugs are used in blind fashion. MMC in 4% and acetic acid in 12.5% saturation are applied. Other visits are completed at next month and 3 months later. Both methods are effective in treatment of granulation tissue. In each group both treatment were effective too but MMC was more effective than acid acetic in the treatment of granulation tissue after 4 weeks. Based on our findings, it is clear that topical MMC is very effective in the treatment of granulation tissue and in CWD. It results in dry cavity much better than acetic acid without any complication.

Topical ciprofloxacin/dexamethasone otic suspension is superior to ofloxacin otic solution in the treatment of granulation tissue in children with acute otitis media with otorrhea through tympanostomy tubes

Objective Comparison of topical ciprofloxacin/dexamethasone otic suspension (CIP/DEX) to ofloxacin otic solution (OFL) for treatment of granulation tissue in children with AOMT. Study design 599 children aged ≥6 months to 12 years with AOMT of up to 3 weeks' duration were enrolled. Patients received either CIP/DEX 4 drops twice daily for 7 days or OFL 5 drops twice daily for 10 days. Granulation tissue severity was graded at clinic visits on days 1, 3, 11, and 18. Results Granulation tissue was present in 90 of 599 AOMT patients (15.0%) at baseline. CIP/DEX treatment was superior to OFL for reduction of granulation tissue at the day 11 visit (81.3% compared with 56.1%, P = 0.0067) and the day 18 visit (91.7% compared with 73.2%, P = 0.0223). Both topical otic preparations are safe and well tolerated in pediatric patients. Conclusion CIP/DEX was superior to OFL in the treatment of granulation tissue in children with AOMT.