In some cases, however, over time the granulation bed does develop a nerve supply. In most cases, healthy young granulation tissue does not have much nerve supply, so proud flesh can be cut away with a scalpel blade without causing the horse much pain. In some cases, sedation is used to help keep the horse still for the procedure. The wound is cleaned and hair clipped away so that the edges of the wound are visible. Vets usually wears latex exam gloves to perform this procedure. Surgical removal of proud flesh begins with wound cleaning. It is your vet's job to determine why it developed and what can be done to promote healthy wound healing going forward. In most cases, it must be surgically removed. But, if you have an older horse or one that has been nutritionally compromised, then the healing process will take longer.Once granulation tissue is elevated significantly above the skin level it is called "Proud Flesh". If the horse is in peak condition and is having all of its nutritional requirements met, then the immune system is working at peak performance and the healing process will be shortened. However, in most lower limb wounds, it is usually a minimum of three to four weeks if a bandage is applied, but it could be as long as several months.Īnother factor that affects the healing process is the physical condition of the horse. If the horse is put in a cast to restrict his movement, it generally takes two to three weeks. Since skin cells have to grow from the edge, the larger the wound, the more time it takes to heal. The healing process all depends on the size of the wound, and how large the proud flesh area has become. Epithelialization is the process of skin cells growing from around the edge of a wound and slowly covering the damaged area. Steroids have been shown to inhibit the formation of granulation tissue without inhibiting epithelialization. Once the excess granulation tissue is removed, a steroid cream or ointment is applied to the area. The surgical method is generally preferred because it removes much of the unwanted granulated tissue and leaves healthy tissue underneath, whereas the caustic method destroys all cells whether or not they need to be destroyed. Using a caustic substance slows the healing process when compared to the surgical treatment of proud flesh. The problem with caustic substances is that their purpose is to destroy cells, and in addition to destroying exuberant granulation tissue, they also destroy healthy cells and might cause further damage to the wound. There are several caustic products on the market. The second option in treating proud flesh is to use a caustic substance to eat away the granulation tissue. This debridement process might need to be performed more than once, depending on the size of the wound and how much proud flesh is present. Once the tissue is debrided, a pressure bandage is applied to help stop the bleeding. While there are no nerve endings in the tissue, there is a tremendous blood supply. In some horses, sedation is not necessary as granulation tissue is devoid of a verve supply. In this process, the granulated tissue is excised to be level with the skin’s edges. First, surgical removal of the exuberant granulation tissue generally provides the best results.
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