granulation tissue

WordNet

1. new connective tissue and tiny blood vessels that form on the surfaces of a wound during the healing process (同)granulation_tissue
2. the act of forming something into granules or grains; "the granulation of medicines"
3. a soft thin (usually translucent) paper (同)tissue_paper
4. part of an organism consisting of an aggregate of cells having a similar structure and function

PrepTutorEJDIC

1. 粒[状]にすること;粒状,ざらざらした状態; / (ざらざらした表面の)ぶつぶつ,粒点
2. 〈U〉〈C〉(生物体の)『組織』 / 〈U〉〈C〉『薄織物』 / 〈U〉〈C〉水を吸収する柔らかな薄紙 / 〈C〉カーボンコピー用薄紙 / 〈C〉《a ~》(…を)織り交ぜて作ったもの《+of+名》 / =tissue paper

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2013/06/06 07:10:24」(JST)

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Not to be confused with Granuloma.

"Proud flesh" redirects here. For other uses, see Proud Flesh (disambiguation).

Granulation tissue is new connective tissue and tiny blood vessels that form on the surfaces of a wound during the healing process. Granulation tissue typically grows from the base of a wound and is able to fill wounds of almost any size it heals.

Appearance

Example of granulation tissue from a cut on a finger with "proud flesh".

During the proliferative phase of wound healing, granulation tissue is:

• light red or dark pink in color, being perfused (permeated) with new capillary loops or "buds";
• soft to the touch;
• moist; and
• bumpy (granular) in appearance.

Structure

Granulation tissue is composed of tissue matrix supporting a variety of cell types, most of which can be associated with one of the following functions:

• formation of extracellular matrix,
• operation of the immune system, or
• vascularisation.

An excess of granulation tissue (caro luxurians) is informally referred to as "proud flesh."

Extracellular matrix

The extracellular matrix of granulation tissue is created and modified by fibroblasts. Initially, it consists of a network of type-III collagen, a weaker form of the structural protein that can be produced rapidly. This is later replaced by the stronger, long-stranded type-I collagen, as evidenced in scar tissue.

Immunity

The main immune cells active in the tissue are macrophages and neutrophils, although other leukocytes are also present. These work to phagocytize old or damaged tissue, and protect the healing tissue from pathogenic infection. This is necessary both to aid the healing process and to protect against invading pathogens, as the wound often does not have an effective skin barrier to act as a first line of defense.

Vascularization

It is necessary for a network of blood vessels to be established as soon as possible to provide the growing tissue with nutrients, to take away cellular wastes, and transport new leukocytes to the area. Fibroblasts, the main cells that deposit granulation tissue, depend on oxygen to proliferate and lay down the new extracellular matrix.

In vascularisation, also called angiogenesis, endothelial cells quickly grow into the tissue from older, intact blood vessels. These branch out in a systematic way, forming anastomoses with other vessels.

Approximate times of the different phases of wound healing, with substantial variation depending on wound size and healing conditions. Granulation tissue formation is seen in green box at days to weeks.

References

UpToDate Contents

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• 1. 創傷の臨床評価 clinical assessment of wounds
• 2. 創傷マネージメントの基本原則 basic principles of wound management
• 3. 創傷治癒および治癒しない創傷の危険因子 wound healing and risk factors for non healing
• 4. 化膿性肉芽腫（小葉状毛細血管腫） pyogenic granuloma lobular capillary hemangioma
• 5. 間質性肺疾患における肺生検結果の解釈 interpretation of lung biopsy results in interstitial lung disease

English Journal

• Application of Cryopreserved Fibroblast Culture with Au Nanoparticles to Treat Burns.

• Volkova N1, Yukhta M2, Pavlovich O3, Goltsev A4.
• Nanoscale research letters.Nanoscale Res Lett.2016 Dec;11(1):22. doi: 10.1186/s11671-016-1242-y. Epub 2016 Jan 14.
• The aim was to investigate a possibility of using the cryopreserved human culture of fibroblasts (CrHFC) with gold nanoparticles (AuNPs) to treat experimental burns in rats.The third-degree burns were modeled in white male rats. All the animals with burns were divided into three experimental groups:
• PMID 26762263

• Temporary Relocation of the Testes in Anteromedial Thigh Pouches Facilitates Delayed Primary Scrotal Wound Closure in Fournier Gangrene With Extensive Loss of Scrotal Skin-Experience With 12 Cases.

• Okwudili OA1.
• Annals of plastic surgery.Ann Plast Surg.2016 Mar;76(3):323-6. doi: 10.1097/SAP.0000000000000505.
• AIMS AND OBJECTIVES: To share our experience on the use of temporary testicular thigh pouches to facilitate scrotal wound closure in Fournier gangrene with extensive loss of scrotal skin.PATIENTS AND METHODS: Patients seen over a 10-year period who had extensive (>50%) loss of scrotal skin preclu
• PMID 25785387

• Fibroblast growth factor 2 dimer with superagonist in vitro activity improves granulation tissue formation during wound healing.

• Decker CG1, Wang Y2, Paluck SJ1, Shen L1, Loo JA3, Levine AJ4, Miller LS2, Maynard HD5.
• Biomaterials.Biomaterials.2016 Mar;81:157-68. doi: 10.1016/j.biomaterials.2015.12.003. Epub 2015 Dec 15.
• Site-specific chemical dimerization of fibroblast growth factor 2 (FGF2) with the optimal linker length resulted in a FGF2 homodimer with improved granulation tissue formation and blood vessel formation at exceptionally low concentrations. Homodimers of FGF2 were synthesized through site-specific li
• PMID 26731578

Japanese Journal

• クリプトコッカス症を疑った左頰部肉芽種の1例

• 羽田 朱里,渡邊 伸也,中島 純子,佐藤 泰則
• 日本口腔診断学会雑誌 27(1), 61-65, 2014
• … The histopathological diagnosis was granulation tissue formation by fungal infection of Cryptococcus, etc. …
• NAID 130003398162

• 多血小板血漿を用いた下肢難治性創傷治療

• 東田 隆治
• The Journal of Japanese Society of Limb Salvage and Podiatric Medicine 6(1), 49-55, 2014
• 要旨：多血小板血漿療法（platelet rich plasma: PRP）は再生医療の一つであり，自家血を遠心分離して得られる血小板を濃縮させた血漿に，血小板凝集反応を起こさせ，活性化させることにより放出された多量の成長因子を創傷治癒の促進に応用する方法である．糖尿病性足潰瘍や重症下肢虚血などの下肢慢性創傷では，肉芽内の成長因子やサイトカインなどがバランスを欠いた状態にあり，デブリードマン，血行 …
• NAID 130003397876

• 喉頭蓋に生じた放線菌症例

• 櫛橋 幸民,金井 英倫,森 智昭,寺崎 雅子
• 耳鼻咽喉科臨床 107(3), 235-239, 2014
• … The result of the pathological examination revealed granulation tissue of the epiglottis caused by actinomycosis. …
• NAID 130003395632

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★リンクテーブル★

リンク元	「肉芽組織」
関連記事	「granulation」

「肉芽組織」

　　[★]

英

granulation tissue

関

肉芽形成

• 基本構成細胞：血管、筋線維芽細胞、炎症細胞間質は浮腫状でcollagenに乏しい。
• 損傷を受けた組織では、一連の炎症が起こる。すなわち初期に好中球が遊走し異物の排除に関わり、次いでマクロファージが浸潤してくる。3-5日目までには肉芽組織が出現する。ピンクで柔らかくでこぼこした組織である。肉芽組織では線維芽細胞の増生、毛細血管新生が粗な細胞外マトリクス中にみられる。肉芽組織に次第に結合組織が蓄積し、ついには瘢痕を形成する。瘢痕は再建されるかもしれない。 (BPT.70)

• 健康肉芽：鮮紅色、出血しやすい、分泌物少ない。　→　毛細血管が豊富に存在し、感染が存在しないことを示唆？？？
• 病的肉芽：蒼白～鮮紅色、出血しにくい、分泌物多い。

「granulation」

　　[★]

• n.

• (炎症病巣のまわりの)肉芽
• (潰瘍基底の)顆粒
• 顆粒化、顆粒形成、造粒