Proud flesh is the common term for an exaggerated scar-tissue response. Basically, it occurs when a healing injury forms granulation tissue at a rate faster than the skin closes over the wound, and the scar tissue starts to extend above the skin surface. Proud flesh looks like a bulging overgrowth of ugly red tissue.
Proud flesh can occur anywhere, but it’s particularly common below the knees and hocks, especially over the back of the pastern/heel area where constant movement is probably a complicating factor. Infection also increases the risk of proud flesh, as does constant irritation from flies.
The sooner you treat developing proud flesh, the quicker it will resolve. However, even large, long-standing problems can be corrected with time and patience. Standard veterinary approaches to treating proud flesh include:
• Resection. Your veterinarian will trim the granulation tissue back so that it’s level with the skin. Resection is a good place to start, especially in cases that have gotten a bit out of control. This minor surgery rarely needs tranquilizers or anesthetics, since the scar tissue isn’t sensitive to pain. Be forewarned, however, that it probably will bleed heavily.
• Bandages. Bandaging applies pressure, decreases movement and helps guard against infection and contamination. Wounds developing proud flesh should be kept wrapped unless a caustic topical treatment is being used.
• Topicals. An old-time remedy that is underutilized today is the application of caustic powder. Typical caustics employed include lime, cornstarch, talc, charcoal, boric acid, aluminum silicates and trace-mineral oxides and sulfates. It’s usually best not to bandage while you are using caustic powder.
Farnam’s Wonder Dust is a good readily available wound caustic powder. Also a good product choice is Blood Stop Powder from Agripharm. You can also use topical hemostatic powders labeled for use after dehorning of cattle. Avoid products that contain mercury or bloodroot, as these can damage adjacent normal tissue.
We also like Veterinus Derma Gel, which is a wound treatment that is effective in encouraging the growth of skin, while minimizing scar tissue formation. This product, available through your veterinarian (see www.equineamerica.com 800-838-7524), is an especially good choice for use after proud flesh has been resected and controlled if skin growth is lagging behind.
Your veterinarian may also suggest tetracycline powder. With large areas of proud flesh, resection should be done first and the powder then applied to exposed, bleeding areas on the scar tissue bed.
With smaller growths, you can mildly irritate the proud flesh by rubbing it vigorously with a dry gauze sponge until it begins to ooze, then apply the caustic powder. A common criticism of caustics is they may harm normal tissue, but this is not a concern if the area is kept dry.