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Observation
What you see. The starting point for addressing any equine health related issue is your observation.

YOU ARE OBSERVING

Proud Flesh, Healing Wound Developed Raised Red Tissue

Summary

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.

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your role

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What To Do

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.

What Not To Do

Do not remove proud flesh from a wound without addressing the problem that caused its development in the first place. The proud flesh may simply reappear.

your vet's role

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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.
Questions Your Vet Might Ask:
  • Can you send a photo?
  • Where, specifically, is the wound?
  • How long has the wound been there?
  • Is there any swelling in the area?
  • Is the horse limping or lame?
  • If the horse is lame, how lame?
  • Are you bandaging the wound?
  • What are you doing to treat the wound?
  • What are the results of the Whole Horse Exam (WHE)?
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Diagnoses Your Vet May Consider

The cause of the problem. These are conditions or ailments that are the cause of the observations you make.

Very Common
Rare
more diagnoses

further reading & resources

Author: Doug Thal DVM Dipl. ABVP