Understanding Proud Flesh

Wounds on horses’ bodies and limbs are exceptionally common. Those on distal (lower—below the knee/carpus or hock/tarsus) limbs are especially difficult to manage, which often leads to the production of proud flesh, or exuberant granulation tissue, resulting in a chronic wound. Early recognition and appropriate treatment are crucial for complete wound healing. Here we’ll explain the wound healing process, appropriate treatment to avoid proud flesh, and what to expect when managing proud flesh with your veterinarian.

How Wound Healing Works

The normal wound healing process includes four stages: hemostasis (clotting), inflammatory (localized swelling), proliferative (rebuilding), and maturation (remodeling). They normally proceed in an organized and linear fashion; however, contamination, infection, inflammation, and motion can halt the progression of healing and lead to chronic wounds.

Proud flesh develops when the normal proliferative phase of the wound healing process proceeds unrestricted. Typically, granulation tissue is pink and appears rough or bumpy. This tissue is highly vascularized but does not contain nerve endings, which means it contains many blood vessels that help supply oxygen to the area but does not have any sensation. Horses are more prone to proud flesh than other species, especially when it comes to wounds on the distal limbs. This predisposition occurs due to the high tissue tension and mobility in these areas. Bandaging and rest are vital to wound healing, as continuous wound movement and contamination cause persistent inflammation, which complicates

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