Proud Flesh

Doc-t October 2, 2016
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The basics of proud flesh – Part 1
The basics of proud flesh – Part 2
The basics of proud flesh – Part 3
A demonstration of removing proud flesh and then wrapping the wound to prevent more.
Skin & hair
System & disease topics

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Reduction of the proud flesh (de-bulking) which allows the surrounding epithelium to migrate across the bed of granulation tissue and heal the skin. Sterility is not required because the wound has healed. The granulation tissue is nature’s bandage. The bleeding from the cut will flush away most pathogens and the antibiotic powder will kill the rest.
Proud flesh on the lateral LF pastern. About 4 weeks old. The owner had tried “everything” all of which promoted the exuberant granulation tissue. The fly was typical. So is the crusty puss. Note the thin pink line of new skin between the black hair and the red granulation tissue. The epithelial cells are here and are easily damaged. The normal granulation tissue has been allowed to rise above the level of the skin. This blocks the migration of the epithelial cells across the bed of granulation tissue. This excess granulation tissue is called “exuberant” or “proud.”
Reduction of the proud flesh (de-bulking) which allows the surrounding epithelium to migrate across the bed of granulation tissue and heal the skin. Multiple cuts can be made to sculpt the tissue to the level of the skin. No drugs are necessary to do this. There are no nerves or pain sensation in the granulation tissue. However, there is in the skin so be careful not to cut the skin of the horse will react.
Reduction of the proud flesh (debulking) which allows the surrounding epithelium to migrate across the bed of granulation tissue and heal the skin. The scalpel blade is parallel to the skin. The goal is to remove the excess granulation tissue to the level of the skin or just below it.
Reduction of the proud flesh (de-bulking) which allows the surrounding epithelium to migrate across the bed of granulation tissue and heal the skin. The blade can be turned in any direction for cutting.
A non-stick pad which allows the owner to remove the bandage without removing the delicate epithelium cells with the bandage.
A handful of 4×4 gauze pads to aid in applying pressure to the wound to keep the granulation tissue below the epithelial cells.
A non-stick pad which allows the owner to remove the bandage without removing the delicate epithelium cells with the bandage. The elastic bandage which applies the pressure needed to keep the granulation tissue below the skin.
The sequence of wrapping the proud flesh wound: The non-stick pad should be sprayed with powdered antibiotics or with nothing as in this picture, but ointments should NEVER be used.
The granulation tissue is highly vascularized so de-bulking is a bloody event. There are no pain nerves in the granulation tissue so de-bulking is pain free. There were no drugs used in this horse to sedate, reduce pain, or locally block. The horse never moved a muscle which is typical.
The sequence of wrapping the proud flesh wound: The non-stick pad should be sprayed with powdered antibiotics or with nothing as in this picture, but ointments should NEVER be used.
The sequence of wrapping the proud flesh wound: 1 of 4 – The non-stick goes on the wound. The gauze pads are placed in between the non-stick pad and the elastic bandage.
The sequence of wrapping the proud flesh wound: 2 of 4 – the bandage is applied with enough tension to keep the underlying gauze and non-stick pad in place and to keep pressure on the wound.
The sequence of wrapping the proud flesh wound: 3 of 4 – The elastic bandage should cover the underlying pads. Too much tension can cut off the circulation to the foot. Gentle pressure is all that is needed.
The sequence of wrapping the proud flesh wound: 4 of 4 – The blood will seep through and this is OK. Replace this bandage in a day with later bandage changes occurring every 3 to 4 days. To prevent this bandage from slipping, apply 1 turn of Elasticon® (elastic bandage with adhesive) at the top of this bandage with ½ on the skin and ½ on the bandage. Do the same on the bottom edge. This will seal out the dirt so the horse can be turned out without worries of wound infection. At the bandage changes, just use a gentle stream of water to knock off the puss. DO NOT SCRUB OR USE SOAPS OF ANY KIND. Just a gentle stream of water and let air dry. This would will take about 30 days to heal.
Summer sore before any treatment or bandaging. 6/25/2019
Summer sore treatment. Granulation tissue on 6/29/2019 after wrapping using a water soluble antibiotic, a non-stick pad and a local pressure wrap (4×4 gauze plus non-adhesive stretch wrap for pressure and an adhesive wrap top and bottom to seal the ends).
Summer sore treatment. Granulation tissue on 7/4/2019 after wrapping using a water soluble antibiotic, a non-stick pad and a local pressure wrap (4×4 gauze plus non-adhesive stretch wrap for pressure and an adhesive wrap top and bottom to seal the ends).
Summer sore treatment. Granulation tissue 9/2/2019 . Not being wrapped for the past 2 weeks due to high moisture in the environment. Using daily hosing plus silver Aluspray®. Note the enlargement under the skin but there is no proud flesh.
Categories: Skin And Hair System

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