Wound Wars: The Battle Of Proud Flesh

Proud flesh:  the nemesis of wound care.  When you have any open wound that can't be stitched (which seems to define nearly all horse wounds), you have to wait for them to fill in on their own with granulation tissue.  However, this tissue has a serious overachievement problem & inevitably multiplies into a cauliflower-esque explosion of cell growth that protrudes well above the skin surface.  It then blocks the migration of healthy skin cells that would otherwise move in to close the wound.

It is particularly problematic in areas of poor blood supply & high motion, like the lower legs.  Where 100% of my horses' wounds were.  Of course.

If the wound in located somewhere you can apply a pressure bandage, like a standing wrap, you can prevent proud flesh.  When those cells can't push outward, they seem to just give up & pout, giving the good cells room to do their magic.  This was awesome for 25% of our wounds, specifically, Solo's skinned cannon bone.

You can see by mid-Sept the bone is once more covered by a sub-layer & as of this weekend, new skin has covered more than 50% of the original area.  I'm keeping a non-stick pad coated with Dr. Bob's Magic Red Sauce + standing wrap on this until it's filled in more, as one less place I have to fight the evils of proud flesh.

Solo's hock has been the primary battleground.  High motion, impossible to pressure wrap, with a horizontal cut destined to pull apart - it was inevitable, really.  The Magic Red Sauce (I don't know all the ingredients in this concoction) is supposed to help both retard proud flesh & encourage epithelial cell growth, but its magic definitely has limits.

I was scrubbing madly with my dilute betadine, but it wasn't enough, so mid-Sept, I called Dr. Bob.  He knows I do surgery on endangered species (& they live), so he gave me permission to get aggressive.  Really aggressive.  I dunked the knife & scissors on my multi-tool in the beta-water & charged back into battle.
 
The one good thing about proud flesh is that it doesn't contain any nerves, just a zillion blood vessels.  So it will make an unholy mess when you hack (very carefully) away at it but your horse won't feel a thing.  This wasn't a super fun addition to the twice-a-day cleanings & it made them even longer, but Solo dozed patiently while I chopped off endless tiny tissue nodules, just trying to keep it roughly even with the skin surface.

Front

Looking good today (white is Corona)

Lateral side

Today's view, still a little proud flesh, but the skin will soon swallow it

After scrubbing, I would alternate between polysporin & Magic Red Sauce.  I am happy to say that after several weeks of battle, not only is the proud flesh on pouty retreat, but the front hole has finally closed, meaning no more diaper wrapping & ending the 2-roll-a-day vetwrap suffering!  There is still some fill in that hock, so it gets hosed daily, but has drastically reduced with today's cooler weather.

Echo's return to work was delayed by the fact that it took me an hour to do Solo's bandage when I got home from work, after which it was basically dark.  He is now back under saddle, though, for the past 10 days.  He is almost completely healed.  The friction burns on his chest have vanished under his new winter parka-in-progress, you can't even tell they were there.

Top is Sept 3, bottom is Sept 27

Proud flesh did rear its ugly head on his knee, so it also got the knife & is now gasping its very last, tiny breaths.  A few more Red Sauce treatments & it too will vanish.  The cut on the outside of his cannon is a small scab hidden in fur.

My knife hasn't been needed in several days.  Both boys are sound & happy.  So much so that my next story for you involves a lesson (OMG, a lesson!!?!) in which Baby Monster is making some very exciting progress.

Coming soon...

Categories: injury, vet care