Exuberant Granulation Tissue in Horses: Pathophysiology and Therapeutic Approaches – An Integrative Review
DOI:
https://doi.org/10.17921/1415-6938.2026v30n2p207-221Abstract
Exuberant granulation tissue (EGT) in horses constitutes a frequent complication of second-intention wound healing, especially in wounds located on the distal limbs. This integrative review aimed to synthesize the available evidence on the pathophysiology, associated factors, complications, and therapeutic approaches related to EGT in horses. Searches were conducted in the PubMed/MEDLINE, SciELO, and LILACS databases, considering publications from 2013 to 2025. After title and abstract screening, followed by full-text reading, 27 studies were included, comprising experimental studies, case reports, clinical series, reviews, and histological studies. The findings indicated that EGT is related to local and systemic factors, such as low perfusion, hypoxia, edema, mobility of the affected region, persistent infection, and bacterial biofilm formation, which contribute to the maintenance of chronic inflammation, delayed reepithelialization, and reduced wound contraction. The therapeutic approaches described were predominantly combined, involving wound bed preparation, debridement, excision of exuberant tissue when indicated, infection control, and the use of adjuvant therapies. In conclusion, EGT remains a relevant clinical challenge in horses, highlighting the need for controlled studies and standardized protocols to strengthen therapeutic decision-making.
Keywords: Horses. Wound Healing. Skin Wounds. Exuberant Granulation Tissue.
Resumo
O tecido de granulação exuberante (TGE) em equinos constitui uma complicação frequente da cicatrização por segunda intenção, especialmente em feridas localizadas nos membros distais. Esta revisão integrativa teve como objetivo sintetizar as evidências disponíveis sobre a fisiopatologia, os fatores associados, as complicações e as abordagens terapêuticas relacionadas ao TGE em equinos. Foram realizadas buscas nas bases PubMed/MEDLINE, SciELO e LILACS, considerando publicações entre 2013 e 2025. Após triagem por títulos e resumos, seguida da leitura na íntegra, foram incluídos 27 estudos, abrangendo pesquisas experimentais, relatos de caso, séries clínicas, revisões e estudos histológicos. Os achados indicaram que o TGE está relacionado a fatores locais e sistêmicos, como baixa perfusão, hipóxia, edema, mobilidade da região afetada, infecção persistente e formação de biofilmes bacterianos, os quais contribuem para a manutenção da inflamação crônica, atraso da reepitelização e redução da contração da ferida. As abordagens terapêuticas descritas foram predominantemente combinadas, envolvendo preparo do leito da ferida, desbridamento, excisão do tecido exuberante quando indicada, controle de infecção e uso de terapias adjuvantes. Conclui-se que o TGE permanece como desafio clínico relevante em equinos, sendo necessária a realização de estudos controlados e protocolos padronizados para fortalecer a tomada de decisão terapêutica.
Palavras-chave: Equinos. Cicatrização de Feridas. Feridas Cutâneas. Tecido de Granulação Exuberante.
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Copyright (c) 2026 Cinthia de Sousa Braga Meneses; Edilson Martins Rodrigues Neto, Lúcia Daniel Machado da Silva, João Emanuel Campelo Cardoso
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