This is an archived Horseadvice.com Discussion. The parent article and menus are available on the navigation menu below:
HorseAdvice.com » Diseases of Horses » Skin Diseases, Wounds, and Swellings » Wounds / Burns » The Treatment of Proud Flesh or Exuberant Granulation Tissue »
  Discussion on Proud Flesh
Author Message

Posted on Tuesday, Jan 2, 2001 - 11:50 pm:

I have a 16 month old quarter horse gelding that cut his near back leg about a week ago just below the front of hock. I have been treating it twice a day by doing the following: initially washing the wound with cold water and a cloth, then applying a sea minerals ointment and then a sea minerals spray. I have, in the last couple of days, been using warm water with a capful of Dettol in the water to wash the wound instead of cold water. I've noticed what seems to be proud flesh (I think) forming and wondered if the change from cold water to warm water could have affected this. The horse is a halter horse and I'd very much like for him not to have any scarring - am I treating the wound right? Any other ideas? I have read the article on proud flesh, but I'm still a bit unsure if what I'm doing is right or wrong.

Posted on Wednesday, Jan 3, 2001 - 7:51 am:

Hello Tracey,
I am unfamiliar with the products you are using so have no opinion on them. I don't think the change from cold to warm water makes much difference. However your question(s) indicates a lack of understanding of normal wound healing. We cover these issues and proper long term treatment of wounds in the 3 articles associated with this forum. Best would be to study the articles and have your vet, who can examine the wound, decide what proper treatment is.
DrO

Posted on Thursday, Jan 4, 2001 - 9:07 pm:

Thanks DrO. I think I'd better re-read the articles thoroughly this time!

Posted on Friday, Jan 5, 2001 - 8:34 am:

Hi Tracey, sorry to hear about your horses injury. May I advice the non-use of Dettol please? It tends to kill skin and flesh which slows the healing process down. I clean wounds with either salt water or Hibiscrub which is antibacterial. Vets these days seem to be encouraging the use of Intrasite gel (it comes in a mushroom-looking applicator) which is commonly used in human medicine too. Proud flesh usually has to be cut away by a vet - don't worry it doesn't hurt as it has no nerve endings. I think you should ask your own vet to assess your horse.

Posted on Monday, Jan 8, 2001 - 7:31 pm:

Thanks, Helen. I have stopped using Dettol as I noticed that it did seem to hamper the healing. I spoke to my vet and surprisingly enough he actually advised against cutting the proud flesh away. He suggested using a lotion called Yellow Lotion on the proud flesh only. As this area is about the size of a ten cent piece and only fairly new he insisted this would be better than cutting it off. Much as I resisted and was very loathe to use Yellow Lotion, he did insist as it was early days so I went ahead and amazingly the proud flesh is gone. I'm back to using just cold water and the sea minerals ointment and spray and it seems to be healing really well now. Thanks, again.

Posted on Tuesday, Jan 9, 2001 - 2:04 pm:

Tracey,
Why did he advise against cutting away the proud flesh? I know of no reasons not to cut away proud flesh, it is the quickest and best way to deal with it, though as you have found out not the only way.
DrO

Posted on Monday, Jan 15, 2001 - 12:08 am:

I'm not sure why he was loathe to come out and cut the proud flesh. I'm only assuming that he preferred to use this as a last resort and that as I had noticed the proud flesh pretty much straight away, perhaps he though it was better to try the Yellow Lotion first. I must admit, from my own experience and from talking to others, that I have found vets here in Australia rather hesitant to conduct any sort of surgery except as a very last resort.

Posted on Monday, Jan 15, 2001 - 6:08 pm:

I have to ask who is you vet? I am in Aust also (syd area) and am always looking into new vets and peoples opinions of them as sometimes regular vet is not available when needed.
I have also found that they give all chances of healing by themselves before surgical intervention.
Julie

Posted on Tuesday, Jan 16, 2001 - 11:19 am:

Hello Everyone,
Cutting off proud flesh is not a big deal. Since exubernt granulation tissue has no nerves in it, it usually is just a matter of trimming the thing with a scalpel blade. No sedatives, no locals, just clean it up before you trim. I assure you having done hundreds of them and having cleaned up the mess of having people try caustic substances on these: trimming them is best though in small cases like this not neccasary. Lets be sure we are talking about the same thing here: proud flesh by definition is not healing well or it is not pround flesh.
DrO

Posted on Wednesday, Jan 24, 2001 - 6:57 pm:

Julie - I'm between Marulan and Goulburn and I use either Ian Nielsen or Ian Hayes. I'm not sure if they do the Sydney area. After re-reading the article on proud flesh (etc), and from DrO's reply, I too understood that there were no nerve endings and that cutting the proud flesh off didn't hurt the horse at all, so it shouldn't have been a problem. But as you say, perhaps they wanted to give it the best chance of healing first. You'll be pleased to know that the wound is now healing extremely well and it looks like there should only be a very minute scar, if any at all. I'm so glad, especially after all the time and effort I'm putting into making sure it doesn't scar!

Posted on Wednesday, Aug 8, 2001 - 5:48 pm:

Good afternoon,

My foal managed to open up a large flap of skin just about the fetlock on one of his front legs. The vet came out, excised the skin, cleaned the wound, added ointment, and wrapped it. All OK.

My ongoing treatment instructions are similar to those found on this site and other places - ointment, wrap, keep it clean, etc. However, she also wants me to scrub away the proud flesh with a dish brush. Every day for five days, every other day for seven, and then evaluate. Clean, ointment, and rewrap each time.

I've seen this work very well on another foal at the ranch, and the vets say it's worked on other horses in the area, even ones that had problems with proud flesh reoccuring after being removed with a scalpel.

However, it seems that this method causes extra pain/trauma that may not be necessary. Simply wrapping the injured leg correctly and excising the proud flesh later might be easier on everyone.

To the foal's credit, he's getting used to it. One person holds him and I clean and bandage the wound and it's over in a few minutes.

Has anyone else heard of this particular method?

-David

Posted on Thursday, Sep 13, 2001 - 9:30 am:

Hi David,

Yes I have heard of this method too. My gelding came in a few weeks ago with a laceration on the face of his hock. The laceration is about three inches wide and two inches thick and cut through the skin and though the supporting structures around the face of the hock (seems, though, the extensor tendon was not damamged). Anyways, we were hosing the area every day, applying furacin gauze and then wrapping. Proud flesh started to form pretty rapidly. We called the vet to come out and cut off the proud flesh. The vet cut off some of the proud flesh, but then instructed me to scrub the rest of the proud flesh twice daily. He said it was too soon to cut it away. He said to scrub the flesh really hard and get it bleeding. He also said water pressure from the hose, directly on the wound would only drive bacteria into to the wound and that the water should be directed at some point above the wound so it gently trickles down the leg and over the wound. I was also instruced to stop using the furacin ointment as this particular vet does not like to use the furacin ointment below the knee or hock. So, I was told to use Zenadine spray directly on the wound, soak gauze with the spray and apply the gauze to the wound and wrap. I have been following these instructions and the wound looks good, but the granulation bed is still not flush with the skin.

Holly

Posted on Thursday, Sep 13, 2001 - 10:26 am:

Hello Holly,
The notion that the water drives in the bacteria into the wound is not true. Direct pressure with the water on the open wound is well studied and understood phenomenea. It requires vigorous water pressure directly on the wound to dislodge the bacteria from the surface. If areas are pocketing up water they are not draining properly and will give you trouble no matter what you do and maybe less trouble if they are well flushed.

Try this experiment to show you one of several principles involved with this process that addresses your vet concern. Take a small piece of foil and roll it into a tight ball about 1/4 inch (1/2 cm) in diameter. Now take an empty pop bottle of any size and lay it on its side. Now place the foil on the lip of the opening into the pop bottle. Now try to blow the foil (the bacteria) into the bottle (the open wound). You will find it pops out every single time. For more see the article associated with this forum.
DrO

Posted on Thursday, Sep 13, 2001 - 4:57 pm:

Dr.O., I am wondering....if a human has an infected wound, would the flushing with water be beneficial? Seems to me it would really deep clean.

Posted on Friday, Sep 14, 2001 - 6:14 am:

Yes, some human centers that deal with difficult wounds use a Water Pick type device for daily light debridement of such wounds.
DrO
Home Page | Top of Page | Join Us!
Horseadvice.com is a BBB Accredited Business. Click for the BBB Business Review of this Horse Training in Stokesdale NC