When was the last time your horse sustained a small cut or scrape? If you’re like most equestrians, it was probably last week. One study found that 40 percent of horse owners reported their horse was injured in the previous year, with wounds being the most common injury. The majority of wounds are mild cuts or scrapes that can heal just fine on their own. But what happens when an injury doesn’t heal the way it should?

Proud flesh is one of the most common issues with wound healing and can be difficult to treat. A high-quality barrier cream can help prevent proud flesh from forming, but management becomes more difficult once excess granulation has occurred. In order to learn how to treat proud flesh on a horse, it’s important to understand the science behind it.

What is Proud Flesh? 

Proud flesh is defined as the overgranulation of the connective tissue and blood vessels in a healing wound. When an injury first occurs, granulation tissue starts to fill in the wound bed. Eventually the skin will close over the area and the wound will be fully healed. Proud flesh occurs when the granulation tissue does not stop, but grows beyond what is needed to close the wound. Red, cauliflower-like flesh begins to protrude out from the injury. The skin cannot close over the protrusion and healing stalls. If proud flesh is not addressed, the tissue will continue to grow, the wound will not heal, and the animal will suffer as a result. 

If you’re concerned about proud flesh on your horse, there are a few easy ways to recognize it: 

1. A previously fast-healing wound has shown no improvement for a period of time 2. Tissue is now protruding above the original edges of the wound. 

3. The protrusion is red, cauliflower-like flesh that may or may not drip fluid. What Causes Proud Flesh? 

In order to learn how to treat proud flesh on a horse, you have to understand what causes it to occur in the first place. Wound healing is quite delicate. If something occurs to disrupt it, proud flesh can appear. 

The healing process can be disrupted by: 

1. Infection
2. Poor surrounding skin health
3. Excessive movement
4. Low oxygen tension
5. Genetic predisposition
6. And more...

Proud flesh is more likely to occur on high-movement areas of the horse, such as the legs, but can occur anywhere with the right conditions. If you notice a wound on your horse that opens during movement, pay close attention. It is at high risk of developing proud flesh. In other cases, increased inflammation creates more lactic acid, resulting in low oxygen tension, and-- you guessed it-- proud flesh. 

Due to its many different causes, it can be difficult to predict when proud flesh will develop. However, there are several ways to prevent it, including using the right products to promote good skin health. 

How Can You Treat Proud Flesh? 

It’s important to work hand-in-hand with your veterinarian to treat proud flesh on a horse. If you suspect proud flesh is developing or your horse has an abnormally healing wound, contact your veterinarian first and foremost to develop a treatment plan. 

Like most things in life, an ounce of prevention is worth a pound of cure. To prevent proud flesh from forming in the first place, it’s important to provide your horse with the best wound care. 

First, work with your veterinarian to ensure that the wound is thoroughly and carefully cleaned to prevent infection from setting in. While it might be your first instinct to reach for a wound spray or powder, these are more drying than creams and gels and can actually deteriorate skin health and delay healing. It’s important to keep the wound clean but moist by using a high-quality barrier cream, like Zarasyl. Veterinarians on both sides of the Atlantic have seen great success when using Zarasyl to manage proud flesh. Dr. Lisa Fortier, James Law Professor of Surgery at Cornell University, reported that “the granulation tissue doesn’t just stay flush using Zarasyl, it stays flat and sub to the epithelium, simultaneously stimulating wound contraction and epithelialization.” 

After proud flesh has developed, managing it without Zarasyl can become difficult. The proud flesh must be removed in order for the wound to start healing again. Usually this is done by your veterinarian who surgically removes the excess granulation. Studies have examined different treatment protocols, including cryosurgery, and the use of plaster casts and pressure bandages. 

The treatment will vary in each situation depending on the amount of excess granulation, if infection is present, and the horse’s environment. As a horse owner, the best thing to do is to focus on preventing proud flesh from forming in the first place and work closely with your veterinarian if you suspect abnormal wound healing. 

Takeaways: 

1. Proud flesh is the excess granulation of tissue that is red and cauliflower-like in appearance. 
2. Veterinarians have reported great success using Zarasyl to manage proud flesh.
3. As a horse owner, you can prevent proud flesh from developing by following best practices for wound care, including keeping the area clean and moist. 
4. A high-quality barrier cream is a crucial part of wound care as it protects the injury from dirt and the elements, while preventing the area from drying out.
5. Zarasyl is an essential part of any equestrian’s first aid kit. Learn more about it here.
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Courtesy of Golden Fleece Farm Marketing, Veronica Green-Gott.