Proud flesh is an excessive growth of granulation tissue that has the appearance of cauliflower. It usually develops over an open wound, and most often occurs in areas of excessive tension and motion. Proud flesh usually is seen in injuries of the distal limbs (below the knee or hock) due to the lack of underlying soft tissue structures, which allows for an excessive amount of tension in those areas. These distal areas mainly are comprised of bone, ligaments, and tendons, and lacks underlying muscle. This anatomy causes the skin surface to be tense, which increases the risk of proud flesh because of the difficulty for skin to grow back over a wound.
The best treatment of proud flesh is prevention, and the best prevention i performing a primary closure (suturing) of the wound immediately, or as soon as possible, after the wound occurs. Proud flesh can become a problem when primary closure is not an option, and the skin has to heal through second intention healing. Second intention healing is when the skin has to heal first by granulation tissue forming over the wound, then the skin grows over the granulation tissue. It is at this point you get proud flesh. Another preventative method is to limit the motion in the area of the wound as much as possible. This is generally done by bandaging, or placing the lower limb in a cast. By reducing the motion in the area, you speed the healing process allowing skin to grow over the granulation tissue, which greatly reduces the occurrence of proud flesh.....
Does anyone have experience with this? Has anyone ever seen this in a dog?
Indy's wound is healing well, but perhaps too well. His granulation tissue has started to overgrow a bit and the skin isn't catching up. At tomorrow's bandage change, Dr Blabs is going to take a closer look at the wound and get another opinion on the healing.