Normally, open wounds heal by filling with granulation tissue between 3-10 after the wound occurs. Granulation tissue is red, lumpy, glistening tissue, with minimal drainage and no smell. I think of granulation tissue as a scaffold upon which skin grows over.
Proud flesh is excessive granulation tissue. It is commonly associated with slow healing wounds, especially on equine lower limbs. It appears as red or pink tissue within the wound bed that grows above the level of the surrounding skin. Proud flesh interferes with the healing process, as it physically prevents the wound from closing in from all sides (epithelialization and contraction).
Importantly, proud flesh is also a sign of an improperly healing wound due to infection, the presence of foreign material, excessive movement of the healing tissues, lack of adequate blood supply, or the involvement of anatomic structures that inhibit the natural healing process.
It is important to determine why the proud flesh developed in a wound in the first place. For any wound that is not healing well or is slow to heal, discuss this problem with your vet.
Treatment of significant proud flesh is usually by surgical removal (excision). Thereafter, topical treatments may be used to prevent reformation of proud flesh.
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Prognosis & Relevant Factors
The prognosis is excellent for uncomplicated proud flesh. However, if the underlying problem that caused proud flesh to develop is not managed or resolved, proud flesh can recur.
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