Healing of open wounds is broken up into stages. Open wounds on the lower limbs open wounds heal by filling with granulation tissue. This mostly takes place between 3-10 days after the wound occurs. Granulation tissue is red, lumpy, glistening tissue, with minimal drainage and no smell. Granulation tissue is full of tiny vessels, and can be thought of 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 (the healing process of epithelialization and contraction).

Importantly, proud flesh can 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.

DIAGNOSIS is usually clear by visual assessment of the wound. Occasionally long-standing proud flesh can turn into sarcoid.

TREATMENT of significant proud flesh is usually by surgical removal (excision). Thereafter, topical treatments ,usually containing steroids, may be used to prevent its re-formation.