Last Updated on February 19, 2022 by Allison Price
Horses’ limbs and bodies are very susceptible to wounds. Distal (lower-to-below the knee/carpus, hock/tarsus) wounds can be particularly difficult to manage. This often leads to exuberant granulation tissue and proud flesh. Complete wound healing requires prompt recognition and treatment. We’ll discuss the healing process and appropriate treatment to avoid painful flesh. Also, we will explain what to do with proud flesh when you consult your veterinarian.
Wound Healing Works
Normal wound healing involves four stages: hemostasis, inflammatory (localized swelling), proliferation (rebuilding), maturation (remodeling), and hemostasis. They usually occur in a linear and ordered fashion. However, they can be halted by contamination, infection and inflammation and may lead to chronic wounds.
When the normal wound healing process continues unrestricted, proliferative phases of the wound healing process are interrupted. Granulation tissue appears bumpy or rough and is usually pink. Granulation tissue is highly vascularized. This means that it has many blood vessels that supply oxygen to the affected area. It does not contain nerve endings. Horses are more likely to be proud than any other species, particularly when it comes wounds on the distal legs. These areas are subject to high tissue tension and mobility. As continuous wound movement and contamination can cause persistent inflammation which may complicate healing, bandaging and rest are essential.
Preventing Proud Flesh
In fact, chronic inflammation and infection are major factors in the formation of proud flesh in wounds. The veterinarian should inspect any wound carefully and remove any foreign material, broken bones, or other tissue that could cause inflammation and infection. It is also important to flush the wound immediately with a balanced solution of saline. Your vet will apply the appropriate dressing or bandage to the wound once it is clean. The type of treatment will vary depending on the case.
Talk to your veterinarian if you notice any deep wounds or large ones, if they are located over structures such as joints or tendons or if there is evidence of proud flesh growth. Sometimes, wounds may need to be closed or debridement of dead tissue. Many companies advertise over-the-counter products that are proud flesh preventives. Honey dressings made from medical-grade honey are very effective in healing wounds. They also provide antibacterial support. Your veterinarian will determine which product is best for you.
The Issue
Your veterinarian can help you manage your proud flesh effectively and efficiently. First, determine if there are any lingering infectious constituents. Sometimes, diagnostic imaging may be necessary to further investigate the case.
Your veterinarian may recommend that you treat the proud flesh with either topical steroids (e.g. Panalog) or surgical debridement depending on the severity of the infection. Topical steroids are used to decrease inflammation and prevent the overproduction of granulation tissue.
When the proud flesh grows higher than the normal epithelium around it, surgical debridement may be necessary. The mountainous granulation tissue is too high for epithelial cells to climb. This causes wound contraction. The best way to encourage wound healing is to trim the granulation tissue so that it’s flush with surrounding epithelium. Because of the large vascular supply and low nerve supply, trimming this tissue will not only be painless but also bloodless. Your veterinarian may recommend skin grafts to cover large areas of wound that are too deep for the skin to grow. This is a laborious process that often requires consultation with a surgeon. Your veterinarian and you can successfully manage wounds that are at high risk of forming proud flesh.
Take-Home Message
Horses with distal limb injuries should be treated quickly to ensure the fastest healing. Your veterinarian should be involved in wound management and evaluation. This will ensure that you get the best possible wound healing.
