1/10/2023 0 Comments Proud flesh![]() This tissue must be removed in order for re-epithelialization to occur. It is recognized by a friable red to dark red, often shiny and soft appearance, which is raised to the level of the surrounding skin or higher. Certain areas - such as the scalp, temples, and lower leg - are prone to forming hypergranulation tissue. Hypergranulation is excessive granulation that rises above the wound surface, imposing a barrier to the inward-migrating epidermis. Once the wound is filled with granulation tissue, it provides a foundation for re-epithelialization. This gives granulation the appearance of red lumps (or granules) within the normal paler pink matrix, and despite this pink to red appearance, granulation does not bleed easily. It incorporates a dense network of blood vessels – newly growing capillaries (in a process known as angiogenesis) with an irregular upper layer creased by the capillaries looping together on the wound surface. Normal granulation tissue demonstrates an elevated cellular density, incorporating a collection of fibroblasts, macrophages, and new vessels in a randomly-organized collagen matrix that forms at the base of open wounds. Hypergranulation tissue must be addressed as it prevents epithelialization and wound healing. It is a condition in which fibroblast and new capillary growth is excessive, resulting in a raised appearance above the wound margins. Home » Clinical Corner » How to Identify and Treat Hypergranulation TissueĮxcessive granulation tissue is often referred to as hypergranulation, overgranulation, exuberant tissue or proud flesh. Learn more about proud flesh on our website at. Rather than waste time and money in trials and errors that could delay your horse’s healing, ask your veterinarian what products are best for your situation. Consult your veterinarian about any wounds that appear deep or extensive, that lie over important structures like joints and tendons, or that already show signs of proud flesh development. For the best healing, wounds should be identified and treated quickly and properly - especially on the lower limbs. Prevention of proud flesh involves good wound management. Proud flesh is not conducive to wound healing as it prevents the wound from epithelializing (the process of the skin cells covering the wound), and sometimes it can become so large it appears to be a tumor, usually obliterating the original wound. Persistent inflammation, along with infection, is a major contributor to exuberant granulation tissue (or proud flesh) formation in a wound. These factors can often halt the normal progression of the healing process and result in a chronic wound. Also, the constant movement of the horse's legs as he walks, turns, and bears weight can greatly impair healing, especially if the wound occurs over a joint. Those on lower limbs are especially difficult to manage, however: there is little extra skin in those areas, making large wounds difficult to close via suturing in addition, wounds on the lower legs are contaminated easily with bacteria since the wounds are closer to the ground, bedding, and manure. American Association of Equine Practitioners - UNDERSTANDING PROUD FLESH Wounds on horses’ bodies and limbs are exceptionally common.
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