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Discussion on When to stop treating the proud flesh?

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Ramona Haskin
Member
Username: Ramonah

Post Number: 9
Registered: 1-2005
Posted on Saturday, Feb 5, 2005 - 6:40 pm:   Edit PostPrint Post

I have a 10 yr old AQHA gelding that was involved in an accident that left an enormous wound on the back of his pastern area. The wound encompasses from the ergot down to 1/2" away from the hair line above the coronet, across the entire back of the pastern and wraps around one side to the front. The accident happened on Dec. 17th. Our vet has been involved the entire time, and has been wonderful. My gelding has had the proud flesh cut off four times already. We seem to have a pretty good handle on it now. My question is this, when do you stop treating the proud flesh? Right now I am treating the wound with Granulex every other day, to prevent more proud flesh from growing. It seems to be working.
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Little King Ranch
Member
Username: Eoeo

Post Number: 122
Registered: 10-2002
Posted on Sunday, Feb 6, 2005 - 8:10 am:   Edit PostPrint Post

Glad you got a handle on it, we have a filly we have been treating since the first of November and we have fought it since then. Her wound is located in front of her right hind leg, just below the hock. I have almost gone on a drinking binge over this and I don't drink. There has never been a more frustrating injury that we have had to treat in over 30 years with horses. I feel so bad for her too. She is a trooper. We tried wrapping, we tried leaving it open, right now we are leaving it open. What an ordeal!!
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Robert N. Oglesby DVM
Moderator
Username: Dro

Post Number: 11994
Registered: 1-1997
Posted on Sunday, Feb 6, 2005 - 9:46 am:   Edit PostPrint Post

If you read our article Ramona, you will see we do not recommend such caustic treatments as they result in a larger scar in big wounds. However now that you are using it you need to discontinue it whenever the granulation bed is below the level of the adjacent skin. For more on this see the article associated with this forum.
DrO
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Ramona Haskin
Member
Username: Ramonah

Post Number: 10
Registered: 1-2005
Posted on Monday, Feb 7, 2005 - 12:45 am:   Edit PostPrint Post

DrO, I did read your articles and every post on the subject. The problem is that where the would is located, every time he moved the wound would reopen, even if wrapped, creating a more condusive proud flesh environment. When we tried to restrict his movements, he became three legged from the initial injury. It is so hard to try to heal a skin wound and deep hematomas at the same time. Last night I discontinued the Granulex, and began the debriedment with a water pick and Nolvasan ointment. Thanks
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Robert N. Oglesby DVM
Moderator
Username: Dro

Post Number: 12001
Registered: 1-1997
Posted on Monday, Feb 7, 2005 - 7:20 am:   Edit PostPrint Post

Ramona, I am sure I have seen dozens of similar and much worse wounds in this area: including those that have almost severed the flexor tendon in the back of the pastern and those thar have run down avulusing large sections of the heel. Caustic powders are simply just that: caustic and because of their effect on healthy tissue contraindicated in my opinion. Proud flesh is simply beds of cappillaries, it can always just be cut away.

Fortunately even very bad wounds in this area heal surprisingly well considering the motion of the pastern and the ease with which these wounds can become contaminated. The water pik I am sure is useful but for large wounds I would think a hose with a nozzle so you can get good pressure more practical.
DrO
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Sara Wolff
Member
Username: Mrose

Post Number: 520
Registered: 1-2000
Posted on Monday, Feb 7, 2005 - 9:53 am:   Edit PostPrint Post

We had a colt with a huge leg wound that required 72 staples. Following the advice of our vet, we continually washed it with hose water, let it dry and rewraped it, until it started to heal. Then covered it lightly to keep flies off. When it started to develop proud flesh, we used nitrate sticks (I think they are called) on the proud flesh only. The wound healed with only a small scar on the inside of the hock.
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Little King Ranch
Member
Username: Eoeo

Post Number: 123
Registered: 10-2002
Posted on Monday, Feb 7, 2005 - 10:01 am:   Edit PostPrint Post

Sara, When it started to heal and got big scabs on it, did you put anything on it? Did you cold water hose it at that point? Cover it at all or just leave it open to the air? EO
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Sara Wolff
Member
Username: Mrose

Post Number: 521
Registered: 1-2000
Posted on Monday, Feb 7, 2005 - 10:25 am:   Edit PostPrint Post

Once it scabbed, I let it alone until scabs came off, then put Vit E oil on fresh bare skin. This was after all proud flesh quit growing. I just remembered that on one really bad place the vet reccomending Reducine (sp?) An ointment you scrub in with a tooth brush. It's in a green and gold tin. Also, after hosing, when wound was fresh, we coated it with antibiotic cream.
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