To understand proud flesh, you have to understand wound healing and granulation tissue. When the skin is cut all the way through, it has to fill the defect in before the skin can grow across the top. The way the body does this is by creating granulation tissue. Granulation tissue is made by organizing clotted blood into very fine blood vessels called capillaries. The capillaries then provide nourishment to new skin cells. Briefly it goes like this:

• Skin Laceration causes bleeding and clots form.
• Blood clots organize into capillaries (granulation tissue)
• Granulation tissue bleeds very easily and new clots form and more granulation tissue is created on top of the old.
• The cycle of bleeding and organization goes around until the skin defect is filled.
• The size of the wound is reduced by contraction of the granulation bed.
• Skin cells migrate over the top of the granulation tissue bed.

This is fine, but horses have a habit of forming excessive amounts of granulation tissue which is known as proud flesh. This report deals with identifying, minimizing and treating proud flesh. For More Information also see:

• First Aid for Wounds
• Long Term Care of Deep Wounds

Granulation tissue is composed of capillaries. It is recognizable by its deep pink color and granular appearance. Since granulation tissue is composed of very fragile vessels, it also bleeds very easily. Granulation tissue does not have nerves and is not sensitive. Granulation tissue begins to form within 72 hrs. of wounding and continues to grow until conditions are such that recurrent bleeding no longer occurs. Besides providing a nutrient source for the news skin cells granulation tissue has several other important functions.

• Resists infection
• Has contractile properties to help close a wound

Fresh wounds are prone to infection but by day six the resistance to infection has become quite strong. There are several reasons for this but granulation tissue filling defects and covering the wound is an important one.