Page 114 - The Veterinary Care of the Horse

ridge of proud flesh protruding above the skin. However, corticosteroids can also inhibit

the growth of epithelial cells at the skin edges and long-term use can prevent the wound
VetBooks.ir • from healing. Corticosteroid and antibiotic combinations are often used.

Application of caustic substances, e.g. copper sulphate Copper sulphate crystals
destroy proud flesh but they also damage the delicate epithelial cells at the wound
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margin. The skin should be protected with a coat of Vaseline before the fine crystals are
applied to the proud flesh. These are bandaged in place with a firm bandage over a non-
stick dressing and an absorbent pad. This method should only be performed under

veterinary guidance.

• Immobilization Proud flesh often forms at sites where there is a considerable amount of
movement. Firm bandaging can help to control the amount of granulation tissue but

sometimes this is not enough. In cases where proud flesh keeps forming below the knee
or hock, a cast may be applied.

• Skin grafting Where there is a large area of lost skin or a recurrent problem with
exuberant granulation tissue, a skin graft may assist healing. Small pieces of skin are

removed from the horse’s neck, flank or thigh. They are embedded at intervals in a
healthy bed of granulation tissue. Not all of the grafts will take successfully, but those

that survive produce a hormone called epithelial growth factor. This stimulates the
division of epithelial cells and inhibits the growth of proud flesh.
• Laser therapy Low intensity lasers can be used to stimulate wound and skin healing. An

experienced operator is essential as incorrect use can encourage the growth of proud

flesh.
• Leaving the wound uncovered Opinions vary on whether some wounds benefit from

being left completely open and exposed to the air. To a certain extent it depends on the
site, the type of injury, the stage of healing and also the individual horse’s healing

response.

With sites such as the head and trunk which are difficult to bandage, wounds are frequently
left uncovered. The management of the horse should be altered to reduce contamination of

these injuries by bedding or hay. The most suitable bedding is clean paper or cardboard and,
with head wounds, the hay should be soaked and fed from the floor.

All lower limb wounds need to be covered if possible until the defect has filled in with
healthy granulation tissue. If healing is proceeding satisfactorily, it is advisable to leave the

dressings on for several days at a time. Where proud flesh keeps developing, the vet may
suggest leaving the wound uncovered for part of the day once healing is nearly complete. The

wound must be kept as clean as possible. This can be achieved by: