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  Discussion on Proud flesh-Preperation H?
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Member:
Leslies

Posted on Wednesday, Nov 5, 2003 - 11:03 pm:

My mare has a 2"X 2" area of proud flesh on her heel from a laceration that is approx. 4 weeks old. The vet said the best thing to do is apply Perperation-H. Has anyone heard of this?
Moderator:
DrO

Posted on Thursday, Nov 6, 2003 - 7:50 am:

How far above the level of the surrionding normal skin is the proud flesh sticking?
DrO
Member:
Leslies

Posted on Thursday, Nov 6, 2003 - 2:43 pm:

Dr. O., The area is puffy- it is about 1/4 inch above being flat. I was told that Prep.-H is great to use by a vet. I'm not really sure at this point if this is in fact Proud Flesh, but I wanted to put something on it to kind of discourage it if that is the direction it is heading. I am planning to leave the dressing off as of today if the other area is doing as well as the other day. This laceration went about a week and a half without treatment. I was on vacation when she got hurt, and the barn did not contact myself, or the vet. She was turned out 24 hours a day. This barn also did not want her foot bandaged, and would not let her stay in a stall. Needles to say I had to move her. When the vet came out he stated that it was a serious injury. He could stick his finger all the way through the cut and feel bone, and it also went underneath the frog as far as he could stick his finger. He was very close to casting her leg, but I was able to keep her quiet enough on stall rest that she did heal fairly well. The area that I am concerned about is the area that was the deepest, and the edges were at least 3 inches apart.
Member:
Westks

Posted on Thursday, Nov 6, 2003 - 6:04 pm:

O my i would at least be soaking in warm water and bentendine/ or iodine
for at least 20 minutes a day, if at all possible
Moderator:
DrO

Posted on Thursday, Nov 6, 2003 - 7:03 pm:

I too cannot tell from your post whether you are experienceing problems with proud flesh yet or not. See the article, Equine Diseases » Skin Diseases » Long Term Deep Wound Care, it explains the difference and may help you with evaluation. The problem with soaking this area is that all that stuff from the bottom of the foot gets "promoted" to the wound and there are organisms that have become resistant to the effects of betadine, particularly pseudomonas. I think better are the treatements we suggest in our wound care articles.
DrO
Member:
Sross

Posted on Thursday, Nov 6, 2003 - 9:33 pm:

I have used Prep H on my vet's recommendation on some nasty wounds, but I've never heard it recommended for proud flesh before.
Member:
Leslies

Posted on Thursday, Nov 6, 2003 - 9:34 pm:

Currently every 2 days her hoof and ankle area is totally scrubed off with Novalson. Then Silvadine cream is applied, and covered with 4 by 4's. Then a 15" piece of thick cotton bandaging stuff(?) that is about a foot wide is cut in half down the lenght. The first half is folded in three layers to go under her hoof, and the other piece is used to wrap around her hoof. This is all cover with vet wrap, and then a thicker sticky/stretchy bandage is applied, then a layer of duct tape. (This is a Percheron horse w/huge feet).
The cut starts on one side of her ankle, goes down thru one heel bulb, into thr frog, back into next heel bulb, and back up and over the other side of her ankle.
Her foot does not touch the ground after the dressing is removed. I sit on a chair beside her, and she rests her foot on my lap. Initially her foot was scrubbed out and packed. The vet did not want me soaking her foot due to contamination, as Dr. O. stated also.
My question is still not answered though. Have you ever heard of using Peparation-H for proud flesh?
By the way, I redressed her foot tonight. I decided to leave it covered until the weekend.
Member:
Mrose

Posted on Thursday, Nov 6, 2003 - 11:22 pm:

I haven't used it myself, but a trainer friend I have swears by it.
Moderator:
DrO

Posted on Friday, Nov 7, 2003 - 5:53 am:

Not for treating proud flesh.

How old is this wound Leslie? This area in particular benefits from protection from contamination and a firm bandage helps healing by keeping the edges of the wound opposed.
DrO
Member:
Westks

Posted on Friday, Nov 7, 2003 - 7:07 am:

I apologize for the bad advice, again the vets here recommended that be done.
Moderator:
DrO

Posted on Friday, Nov 7, 2003 - 7:19 am:

I would not call it bad Janette, I just have a different opinion and...really good luck with severe injuries to the foot. I do like to think I have logical reasons for my recommendations but the vast majority of your posts are excellent and we appreciate your help.
DrO
Member:
Aaring

Posted on Friday, Nov 7, 2003 - 8:02 am:

Best product I've seen for preventing the growth of proud flesh on wounds is Dermagel, which you must get from your vet. Amazing stuff!
Member:
Westks

Posted on Friday, Nov 7, 2003 - 8:12 am:

Thank you Dr O that means alot to me coming from you :-)
I do try very hard to make sure that my suggestions will not cause more harm though and that one very well could have.
Luckily it was here that I made it and there are other choices here that one doesn't always get from the local vet.
Member:
Leslies

Posted on Friday, Nov 7, 2003 - 12:19 pm:

Dr. O., The laceration occurred sometime between October 2 and October 12th. The part of the wound on her heels is well approximated with just a slit left. I assume that this will grow out. The area above her heel is the area that was gaping open on October 13th when I came home from vacation. This area had purulent drainage also. Now the gaping area has filled in with granulation tissue. This is the area that I am concerned with. There is abosulutly no infection at this point, and I am able to keep it wrapped. It just appears that The moisture in this area would not promote the wound to finish healing.
Thanks Dr. O., and everyone else whom took time to give me advice. I love this site.
Leslie Sartori
Member:
Nathalie

Posted on Saturday, Nov 8, 2003 - 5:38 am:

I suggest use Calendula (Marigold) I've used it multiple times on serious injuries (mostly on legs) and hardly ever ended up with proud flesh (while the vet told me there would be proud flesh with wounds like they had). I normally scrubbed the wound twice a day with Novalsan and then applied the Calendula. In beginning wrapping the wound to keep wound clean from dirt entering). If you want I have loads of pictures from before and after.
Member:
Mrose

Posted on Saturday, Nov 8, 2003 - 10:54 am:

Our vet once had me use silver nitrate (I think it was) sticks which burn off the proud flesh and allow "good" flesh to grow in. This was on an injury on the coronet band which vet said is an area prone to growing proud flesh. I applied it twice a day. Then once area started to heal over correctly I kept it covered with Vit E oil and just light gauze wrap to keep it clean.
Moderator:
DrO

Posted on Sunday, Nov 9, 2003 - 8:12 am:

Hello Sara,
The principle here would be the same as more commonly available proud flesh medications and still not my first choice because of the slowing of normal skin growth and larger scar formation. For more on this see the article on long term wound care.

Nathalie your good results are do more to your otherwise excellent wound care and less so to the Marigold preparation.
DrO
Member:
Amara

Posted on Sunday, Nov 9, 2003 - 7:57 pm:

well, cant say as i've ever used calendula for proud flesh, but i have seen some amazing results from it..
we had a horse that had colic surgery and several days after coming home some of his staple area was quite oozy... the vet looked at it and was a bit worried, but not enough to be ready to jump into anything at the moment, but to let him know if it looked at all worse... that evening i put calendula on it, and by the next morning ALL the oozy had cleared up-completely.. it was the only thing that had been done to it..
is it possible the area cleared up on its own? certainly, but as it had been oozy for a couple of days i'm a bit sleptical about that... i do think the calendula made the difference, IMO
Member:
Imogen

Posted on Monday, Nov 10, 2003 - 1:57 am:

I'm going to get killed for this and sorry, I know it's not quite the topic of this thread but... Melissa, this is what I always think about "magic" natural remedies.

If they actually worked so well, do you not think that Johnson&Johnson, SmithKline Beecham etc. would not be out there producing them and marketing them on a scale which would make serious money, patent or no patent? Where is the research to show that they work? Why trust science to make your car (sorry, automobile) go but not on wound care? Do you put "alternative" oil in your car's gearbox?

We used to sell calendula (marigold) ointment in Culpeper the herbalist's where I worked in the mid-1970s. It was my unscientific guesstimate that about one quarter of the customers came back for more. Now you could argue that this means it worked and they didn't need it any more. But given most people get cuts and scrapes all their lives, I would say it meant it didn't work well enough to require another (small) tube for three quarters of the customers.

All the best, sorry for any unintended offence caused.

Imogen
Moderator:
DrO

Posted on Monday, Nov 10, 2003 - 7:00 am:

Hello Mellisa and Imogen,
So often both alternative and traditional treatments are given the nod because something natural happened: the problem got better, as it so often does all by itself. I am not picking on natural therapies either. We had a post just last week where someone states I gave it antibiotics and it got well so it must have been a bacterial infection. My thoughts were, "perhaps, but this is what would have happened more than 3/4 of the time if you had shaken chicken bones in a sock at the horse".

But here is my big worry, you did this without some proof this might be effective or at the very least not dangerous. There are no controlled studies I know of for the use of such on surgical wounds of this type.

Calendula preparations are known skin irritants, even if mild, have been associated with moderately severe contact dermatitis (allergic reactions), and is an effective molluscicide (it kills snails partially by disturbing the tissues of the mouth and stomach). It does not appear a good choice for putting on a fresh suture line. You lose the suture line and I don't have to tell you what a mess that might be. Your experience turned out well but was this because of your therapy or in spite of it, the current research suggests the latter but further more specific research in warranted.
DrO
Member:
Amara

Posted on Monday, Nov 10, 2003 - 2:25 pm:

no offense taken imogen!!!
while i tend to go for more natural remedies, it doesnt mean its the right way all the time.. it worked for me in that situation..maybe the ooziness would have went away without it... who knows?..i've used it several times with no problems, and just had an interesting case of ringworm (on myself)clear up literally overnite from applying a DrOp of melrose essential oil... i had tried regular OTC stuff and nothing was working, and didnt have the money to get prescript. stuff...
having said all this, i'm on month 5 of antibiotics from a chronic case of lyme, so i'm certainly no die hard naturalist!

whatever works for each person
but please dont get me started on the drug company stuff...*BG*
Member:
Imogen

Posted on Tuesday, Nov 11, 2003 - 1:51 am:

Dr O, it was me who said "must have been a bacterial infection if it got better" though that's not exactly what I meant!

The point of that thread was I was trying to avoid giving the horse antibiotics and leave it get better on its own - I had to admit defeat because it just would not clear up given plenty of time, and it was preventing me from working the horse.

I actually thought the vet had given the antibiotics to me to keep me quiet which happens a lot here (it wasn't the usual horse specialist vet I normally use) so I delayed using them too... and I was very surprised by the immediate improvement in 24 hours when I did use them... but I quite agree, it could have just been a coincidence!

All the best

Imogen
New Member:
Unis11

Posted on Sunday, Jan 25, 2004 - 9:56 am:

My mare is in foal and scaped her back the other day rying to go through one stall to another. It took off a large patch of hair (about 4" x 3") There was no bleeding. I cleaned the area and applied topical bacitracin on area. Should I be doing anything else at this time? Salley}
Moderator:
DrO

Posted on Monday, Jan 26, 2004 - 8:22 am:

Since ther was no bleeding, probably not, but to know for sure requires an exam.
DrO
Member:
Jewel318

Posted on Saturday, Jul 1, 2006 - 2:18 am:

I once was told that an injury to the bulb of the foot was very serious and most likely would result in permanent lameness. A horse at our barn recently injured himself (hooves too long and he crossfires) on the hind hoof, the injury is about an inch to 1 1/2 inches long and fairly deep. I certainly would have called the vet out but she said no. I suggested that she at least cold hose the wound once if not twice a day and possibly wrap and support the area. She opted for nothing.
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