Veterinary Wound Healing Association 5th Congress, Hannover, Germany. May 10-12 2001
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| EQUINE SARCOIDS – A VIRAL WOUND INFECTION Hans Broström DVM, PhD, Assoc Prof Surgery, Dept Large Animal Clinical Sciences, Box 7018, SLU S-750 07 Uppsala, Sweden. e-mail: hans.brostrom@kirmed.slu.se Equine sarcoids or angleberries are fibroblastic skin growths with variable epithelial participation that comprise the most common tumor in equine practice. The disease has been attributed both to papillomaviruses and retroviruses, or both. The tumor may appear in wounds during the proliferative stages of wound healing, or, more often, at the wound site several months after obvious termination of original wound healing. Sarcoids may, however, also appear unassociated to known previous injury. The disease shows a genetic predisposition linked to immune response genes of the Equine Major Histocompatibility Complex (MHC) as assessed by the Equine Leukocyte Antigen System (ELA). Gross appearance of sarcoids may vary from neglected small warty nodules to large, severe lesions resembling exuberant granulation tissue (“proud flesh”). The tumors may be notoriously difficult to treat due to large size, multiple appearance, localization to sites compromising excision (eye lids, coronary band) and, above all, high rates of recurrence after surgery. This reflects autoinokulation and the difficulty to assess the borders of the tumor during surgery. Therefore, certain surgical measurements are essential prior, during and after surgery to obtain good post-operative results. Complementary to sharp excision may be used immunotherapy, cryo- or chemotherapy. To minimize the risk of development of sarcoids and/or exuberant granulation tissue in wounds, especially at the lower parts of extremities, prophylaxis, in the form of initially correct wound treatment, is essential. This includes, besides tetanus prophylaxis, earliest possible wound treatment comprising wound lavage, careful aseptic wound debridement, prevention of bacterial contamination/infection, efforts to obtain primary healing, and drainage and reconstructive surgery if necessary. At the end, the wound should be protected by casts or firm bandages. The use of prophylactic, systemic antibiotic therapy must always be considered. Studies have been carried out to assess if the most likely course of the disease could be predicted on the basis of clinical parameters (and ELA) which, in extension, would provide rational decisions for therapy. The incidence of “spontaneous” regression and possible parameters associated with these events were also analyzed as were factors promoting surgery and increased/decreased risk of recurrence. Return to index of Abstracts | About the VWHA |