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Discussion on Questions about wound
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Member:
leec
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Posted on Monday, Jan 22, 2007 - 1:06 am:
Hi Dr O,
On Dec 30 my coming 2 yr old filly acquired about a 1.5” long by half an inch wide gash on the back of her left hind fetlock, forward of the ergot. I noticed it when I brought her in from turn-out that afternoon. It was not ragged or bloody, there were only some very slightly blood tinged icicles on her fetlock hair. The wound was clean, as we have deep snow and the temperature freezes any poop almost as soon as it hits the ground... She was not lame and there was no heat or swelling. My vet advised me to not bandage it and to apply Green Wound Cream (has an antibiotic in it) when I bring her in at night. I have been doing this since Dec 30 and I have seen no change in the wound (I was told to keep an eye out for proud flesh). The wound looks the same every day - a smooth flesh coloured ‘mark’. When proud flesh starts, what exactly does it look like? I have seen the end result of it, but never the first stages. How long should it typically take a wound like this to heal? I’m sure it gets its share of ‘chafing’ when she walks through deeper snow – would this be a good thing or a bad thing?
Thanx,
LeeC
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Moderator:
DrO
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Posted on Monday, Jan 22, 2007 - 6:17 am:
Hello Lee,
It is not so much the length Lee as it is the depth that determines how long to heal because deeper wounds must heal from the inside out. I have noticed, and we have had others post on these boards, that lower leg wounds heal slower when it is very cold. Bandaging, if it can be kept dry, will keep it warmer and therefore may speed up healing. Concerning the development and appearance of proud flesh we go into some detail on this in the article Diseases of Horses » Skin Diseases, Wounds, and Swellings » Wounds / Burns » The Treatment of Proud Flesh or Exuberant Granulation Tissue. A couple of good pictures might help us give you further advice. Maybe most important, what are the active ingredients of the green wound cream?
DrO
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Member:
leec
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Posted on Monday, Jan 22, 2007 - 8:22 pm:
Hi Dr O,
Thanks for your reply. I did read the article and some of the posts, and I assume by the information that proud flesh presents itself as a whitish lumpy tissue. Am I correct? Because of my current 'horse housing' situation, it would be difficult to keep a bandage dry or on for that matter. The last time I tried to bandage her for something else, she pulled it off and tried to eat it, even after I sprayed it with some nasty tasting gunk. She does not just chew on fabric like materials, she actually tries to swallow them. My vet is aware of this oddity and knows she can't be watched all day (we are at work), so for this reason and because of the problem of keeping it dry, we elected not to bandage. I left a message for my vet to call me with the ingredients of the Green Wound Cream. I won't be able to get any pictures until the weekend. It is dark when I leave for work in the morning and dark when I get home - I don't think they would turn out that well with the wound being lit by a flashlight... I will keep you posted.
Thanx,
LeeC
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Moderator:
DrO
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Posted on Tuesday, Jan 23, 2007 - 7:54 am:
From the proud flesh article: "It (granulation tissue) is recognizable by its deep pink color and granular appearance." Use the flash but be sure the horse is use to it first.
DrO
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Member:
leec
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Posted on Thursday, Jan 25, 2007 - 12:39 am:
Hi Dr O,
Don’t know where I got the 'whitish' from... I was reading an article in a book on wounds and the picture showed white lumpy tissue. It didn’t say it was proud flesh, but the image obviously stuck in my brain... I spoke to my vet 2 days ago at great length about it and I’m pretty sure my filly does not have any, or at least not too much. The wound is slightly lower than the surrounding skin and when I scrape it, it does not bleed. It is not so tender that Sienna tries to pull her leg away, but she does tense up a bit. I’m told the Green Wound Cream is of no use if there is proud flesh, as it won’t penetrate it. I did not have anything to write on at work when the vet was telling me what was in it, but the key things I remember are it contains a steroid and an antibiotic - don't know if that is enough info to be of any use! Anyway, she was not concerned by what I described, but told me to check it carefully daily and let her know if anything changes. When I am taking pictures of Hanah's hoof this weekend, my mare recovering from WLD, I will take some of Sienna's wound also.
Lee C
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Member:
leec
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Posted on Monday, Jan 29, 2007 - 12:25 am:
Hi Dr O,
Below is what Sienna’s wound looked like this afternoon after she was in the snowy pasture all day. This is, uh, the yuckiest it’s ever looked. Mostly, it has been a nice smooth flesh colored mark as I described before – almost like human skin. I think maybe what has happened is there was proud flesh there, and the crusty snow has scraped it off. Or is the goopy red mess in the photos the actual proud flesh? When I scraped at it on Jan 23rd (5 days ago), it did not do this. I thought I was applying quite a bit of pressure – could it be that the proud flesh has only developed since? In the photos (because of the flash maybe) it looks like the wound is bulging beyond the edges of the skin, however it is only just even with. Do you think I should scrape it down deeper or leave it as it is?
Thanx,
Lee C
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Moderator:
DrO
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Posted on Monday, Jan 29, 2007 - 7:05 am:
After reading the article on proud flesh, what do you think? Is it proud flesh or not?
Concerning the other questions they seem to rely on having seen the injury before and after, something I did not do. I must say all in all the wound looks healthy and healing well. What about the proud flesh Lee?
DrO
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Member:
leec
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Posted on Monday, Jan 29, 2007 - 10:40 pm:
Ha-ha! I do love a test, Dr O! As I look at my photos while reading the article again, I do believe what I am seeing is a bed of granulation tissue, not proud flesh. Do I pass or fail?!
Thanx,
Lee C
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Moderator:
DrO
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Posted on Tuesday, Jan 30, 2007 - 6:21 am:
In truth, I can't tell Lee, the pictures are at a straight on aspect that makes deciding how far it stands out hard to assess. You need to look at the actual injury not the photos to make this assessment.
DrO
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Member:
leec
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Posted on Tuesday, Jan 30, 2007 - 8:43 pm:
Oops, sorry Dr O, I should have added, "...and based on the fact that when viewing the actual wound from all angles, the tissue does not extend beyond the level of the skin...".
Lee C
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Moderator:
DrO
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Posted on Wednesday, Jan 31, 2007 - 7:03 am:
There you go, you now are an approved assessor of excessive granulation tissue.
DrO
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Member:
leec
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Posted on Wednesday, Jan 31, 2007 - 9:38 pm:
Yahoo!
Lee C
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Member:
corinne
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Posted on Thursday, Feb 1, 2007 - 4:17 am:
Good on you Lee! Your too funny and it looks like you are on the right road getting that wound healed. Continued success!
v/r
Corinne
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Member:
leec
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Posted on Thursday, Feb 1, 2007 - 8:57 pm:
Thank you, Corrine. The skin is starting to close in around the edges of the wound and it looks very nice - I will try for an updated pic this weekend.
Lee C
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Member:
leec
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Posted on Tuesday, Feb 6, 2007 - 10:31 pm:
Hi Dr O,
This wound did something different through the course of today... Since Jan 30th, it was back to it's smooth flesh coloured mark and was flush with the edges of the skin. Tonight it was very slightly higher than the edges of the surrounding skin and was the texture of a scab... I lightly scratched at it, but then thought to myself perhaps if it is a scab it should be left alone. If it is not possible for such a wound to 'scab over', than it appears I am seeing/feeling some excessive granulation tissue. If this is the case, will it cause major complications if I wait until the weekend to remove it (so I can do it in the daylight)? Do you think it is something I should have my vet do rather than attempting myself?
Thanx,
Lee C
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Moderator:
DrO
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Posted on Wednesday, Feb 7, 2007 - 6:26 am:
Lee, what do you think, does it look like a major complication? Let the hose decide whether the scab should be removed if the hose dislodges it, it was meant to go if it does not it was meant to stay.
Concerning removal of the proud flesh the bottom line is, "how comfortable are you with a razor blade against the leg of your horses?"
DrO
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Member:
corinne
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Posted on Wednesday, Feb 7, 2007 - 5:07 pm:
Dr O I like your thinking that if a hose removes it it was meant to be debrided if it doesn't leave it alone. Interesting! Thank you for that tip. Lee keep us posted.
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Member:
leec
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Posted on Wednesday, Feb 7, 2007 - 9:31 pm:
Well, the scabby covering was gone when I came home this PM and the wound was pretty much back to a nice smooth surface... I believe it is Mother Nature (the snow) that is doing all the work for me! The wound is now again level with the skin. Whew! No, Dr O, I don't think I would be comfortable holding a razor and my horse's leg at the same time...
Lee C
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