Proud flesh

The best way to prevent proud flesh from forming is proper wound management, says Kim Dyson.

Proud flesh
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You can make your field as horse-friendly as possible, but somehow a horse will go out of its way to find a way of hurting itself – and the presence of ‘proud flesh’ is an indication that something has gone wrong during the healing process. Proud flesh is most likely to be found from the knee down on the front legs and from the hocks down on the hind legs.

Proud flesh is exuberant granulation tissue. The development of this tissue is essential for the efficient healing of a wound, but the process can get out of control. The result is a lumpy, bumpy wound that won’t heal and can affect the movement of a leg. But why is all this granulating tissue such a problem? It’s very difficult for skin to grow over a mountain or through a valley. A nice flat area to grow across until the torn edges meet in the middle results in a healed wound.

Stitching up the wound helps speed up the meeting of these two pieces of flesh. Unfortunately, some wounds are in such a place this isn’t possible. And a heavily contaminated wound shouldn’t be stitched. This means you’re left with an open wound. If you can limit movement of the limb you limit the tension on the wound. Movement disrupts healing. You may feel sorry for your horse being confined to a stable – for at least 10 days – but in the long term you’ll be grateful when the wound heals perfectly and quickly.

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Leg wrap
If you’re going to use a leg wrap, always bandage the opposite leg (both front or both hind legs) and be careful to apply moderate pressure evenly all round. If the bandage is too tight, restricted blood flow will slow healing, further aggravate the injury, and encourage what you want to avoid: proud flesh. Keeping the area closed for two to 10 days helps speed up healing.

It’s essential to change the bandage every eight hours and ensure that there’s adequate padding under the bandage. The light pressure from the bandage keeps the wound clean and flat. Irritation will stimulate granulation. Everything from dirt and bacteria to abrasive soaps and antiseptics can cause problems. As the tissues become more inflamed, the body’s response is to create additional granulation in an effort to heal.

Peach leaf water
Insects also cause enough irritation to stimulate granulation. Secondary trauma to the site, like biting, scratching, or sudden movement, can slow the healing process, which can stimulate granulation, again resulting in proud flesh. Clean the area with boiled peach leaf water (a handful of clean, insecticide-free peach leaves, boiled for 10 minutes in 250ml water and strained; use only the water) and salt. Clean regularly. Steroidal ointments prevent granulation. After cleaning the wound, apply the ointment on a clean nappy or sanitary towel and bandage.

Contact Kim Dyson on 082 888 6511 or at [email protected] with ‘Horse therapy’ in the subject line of your email.