Horse Side Vet Guide ®

Equine Health Resource

Proud Flesh

Synonyms: Excessive Granulation Tissue

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.


  • Why is proud flesh developing in this wound?
  • Is there an underlying infection or other problem causing it?

    Prevention involves proper wound care, confinement to reduce movement of healing tissues, and bandaging with dressings that impede the development of proud flesh.

    With any wound, it is critical that you perform the treatments and management of the equine just as your vet suggests. If you are doing bandage changes on a challenging wound, be sure to communicate using photos, so your vet stays well informed of the wound's healing progress and can advise you on dressings and treatment.

    Helpful Terms & Topics in HSVGWritten, Reviewed or Shared by Experts in Equine Health

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    Author: Doug Thal DVM Dipl. ABVP


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