Management of exuberant granulation tissue

Exuberant granulation tissue is common in large, lower limb wounds of horses, particularly horses of large body size. Methods of control include chemical cautery, cryogenic surgery, and surgical resection. Surgical resection is preferred because it is easy to perform, provides tissue for histologic evaluation, and preserves the epithelial margin. Effective treatments to prevent the formation of granulation tissue include leaving granulating wounds open to the air or, possibly, bandaging with topical steroids. Bandaging or casting may promote exuberant granulation tissue in wounds in which it has already formed, but bandaging and casting are still important in the early management of lower limb or hock wounds in horses. The use of skin grafts or delayed secondary wound closure is frequently necessary to prevent the recurrence of exuberant granulation tissue.