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Proud Flesh and How to Prevent It

Your horse has a wound that just won't heal. It's filled with a wad of pink, fleshy tissue that seems to grow bigger every day. Uh-oh! Proud flesh - and it needs to be treated now.

What Proud Flesh Is:
As your horse's wound begins to heal, pinkish granulation tissue fills in the gaps between soft tissues. Granulation tissue normally stops forming as the skin edges grow together to close the wound. But when healing doesn't go according to plan, the granulation tissue becomes exuberant-it keeps growing until it bulges above skin level, so newly formed skin can't grow over the wound. That's proud flesh.

When Proud Flesh happens:
Proud flesh tends to form in wounds below your horse's knees and hocks, where there's little soft tissue between skin and bone, and where movement constantly tugs the wound's edges. It's most likely to occur in places with lots of movement, such as over joints, or when a complication, such as infection, slows healing.

How to prevent Proud Flesh:
Minimize movement and prevent infection by taking the following steps.

  • Have your veterinarian suture the wound (if it can be sutured), as soon as possible. Call him or her for suture advice.
  • Bandage with a pressure wrap to help hold the wound's edges together.
  • Keep your horse as quiet as you can while the wound heals. When possible, stall rest may be best.
  • Follow your vet's advice for keeping the wound clean and covered, and administer antibiotics per his or her recommendations.

How to treat it:
If proud flesh appears, this strategy will humble it.

  • Trim. Ask your vet to trim the tissue back to skin level, so your horse's skin can begin to grow across the wound. (Note: Proud flesh bleeds heavily when trimmed, but it has no nerves-so your horse won't feel pain.)
  • Wrap. Keep a pressure wrap on the wound to prevent the proud flesh from bulging above the skin again. This also helps to immobilize the wound, furthering the healing process.
  • Medicate. Ask your vet to recommend a topical cortisone preparation (often combined with an antibiotic). Cortisone slows the growth of granulation tissue and can even help shrink proud flesh.
  • Ask! Check with your vet before applying over-the-counter proud-flesh "remedies." Some are designed to cauterize, or burn the tissues. While this may make proud flesh appear smaller, it discourages the wound from healing properly.
  • Don't give up! If the proud flesh bulges again, it may need another trimming-and another, and another. Persist, and you'll win.
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Barb Crabbe is an Oregon-based equine practitioner.

This article first appeared in the December, 2000 issue of Horse & Rider magazine.

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