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#Changes in the Tissues following upon the successful Lodgment of Tubercle Bacilli.# The action of the bacilli on the tissues results in the formation of granulation tissue comprising characteristic tissue elements and with a marked tendency to undergo caseation.
Ultimately the dead bone becomes loose and lies in a cavity a little larger than itself; the wall of the cavity is formed by the new case, lined with granulation tissue. The separation of the sequestrum takes place more rapidly in the spongy bone of the ossifying junction than in the compact bone of the shaft.
Immobilization as for fracture is not necessary but, nevertheless, movement is to be restricted as much as possible. In case of open wounds, the exposed tissues are cared for along general surgical lines. Where the divided parts of the tendon are maintained in fairly close and constant relation, granulation of tissue, sufficient to sustain weight takes place in from six weeks to three months.
The disease begins on the foot as an indurated patch, which becomes discoloured and permeated by black or yellow nodules containing the organism. These nodules break down by suppuration, and numerous minute abscesses lined by granulation tissues are thus formed. In the pus are found yellow particles likened to fish-roe, or black pigmented granules like gunpowder.
If the lips cannot be drawn together and there be no surgical skill at hand to assist them with stitches or bandages, then the gap will be filled up by the fibrous transformation of this granulation tissue and a thick, heavy scar result.
The extent of the wound influences the rate of healing; it is only natural that a long and deep wound should take longer to heal than a short and superficial one, because there is so much more work to be done in the conversion of blood-clot into granulation tissue, and this again into scar tissue that will be strong enough to stand the strain on the edges of the wound.
Abrasions and superficial wounds usually heal under a scab. The scab is formed by the blood and wound secretions. This protects the surface of the wound until finally the destroyed tissue is replaced by the granulations, and the skin surface is restored. Abnormal granulation is not an uncommon form of healing in domestic animals.
The action of the threads is to convert the cyst wall into granulation tissue, which undergoes the usual conversion into scar tissue. If the cyst re-forms, it should be removed by open dissection under local anæsthesia. Puncture with a tenotomy knife and scraping the interior, and the injection of irritants, are alternative, but less satisfactory, methods of treatment.
They grow until they reach the level of the surrounding skin, and so fill the gap with a fine velvety mass of granulation tissue. At the edges, the young epithelium may be seen spreading in over the granulations as a fine bluish-white pellicle, which gradually covers the sore, becoming paler in colour as it thickens, and eventually forming the smooth, non-vascular covering of the cicatrix.
If the synovitis or arthritis remains non-infected and the wound, traumatic or surgical, is not too large, healing by granulation occurs, and the discharge of synovia ceases.
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