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Proud Flesh, Healing Wound Developed Raised Red Tissue

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Code Yellow - Contact Your Vet at Your Convenience for an Appointment

    Open wounds in horses heal through overlapping phases, beginning at wounding. it is important that each of these phases functions properly, in order for a wound to heal cosmetically and functionally in a reasonable period of time.

    The second phase of wound healing is called granulation, in which a scaffolding of budding vessels and connective tissue (granulation tissue) begins to fill the wound bed. Granulation tissue formation is critical to wound healing but can become excessive under certain conditions.

    Proud flesh (excessive granulation tissue) is commonly seen in slow healing wounds, especially in the lower limbs. It appears as red or pink tissue within the wound bed that becomes known as “proud” when it grows above the level of the surrounding skin. Proud flesh can stop the healing process, as it physically prevents the wound from closing in from all sides – the processes of wound contraction and epithelialization.

    Importantly, proud flesh is also a sign of an improperly healing wound due to an underlying problem. This might include infection, the presence of foreign material in the wound, excessive movement of the healing tissues, lack of adequate blood supply, or the involvement of anatomic structures that inhibit the natural healing process.


    Take a photo of the wound and share with your vet. The proud flesh may need to be removed and the underlying conditions that caused it addressed.


    By evaluating the wound, your vet identifies the factors that interfere with healing and result in the development of proud flesh. The appropriate treatment will depend on those factors.

    Occasionally other conditions mimic, or appear to be proud flesh (e.g. sarcoid and mast cell tumor).

    There are lots of commercial products that help reduce or prevent the formation of proud flesh but, in some cases, there is an underlying problem that needs to be solved first.

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

    Author: Doug Thal DVM Dipl. ABVP


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