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RE: [RC] the healing process and proud flesh - Susan E. GarlinghouseHere is how I manage this type of wound. Yes, it will take sedation at least the first time to adequately handle the leg. If there is currently proud flesh forming, then it needs to be carved back down to the level of the 'normal' surrounding skin. There are no nerve endings in granulation tissue, but tons of vascularization, so it will bleed like a stuck pig. I don't like Wound Dust, or any other irritating substances, and the research on wound management is that they just make things worse overall. If a wound is fresh, then use a triple antibiotic ointment, a firm clean dressing and that's it. If it's proud flesh that has been carved down, then you use an antibiotic cream with steroids that will suppress further granulation formation. Apply a non-stick telfa pad, and put a firm pressure wrap on, usually bandaging well above and below to keep the wrap in place and uncontaminated. You have to know what you're doing to apply enough pressure without causing further injury, rolled cotton or a combo wrap for padding is very useful. Brown gauze, vetrap, elastikon over that and leave it alone. The less movement to the joint, the less future proud flesh formation there will be, so confinement to a small pen or whatever is preferred. She shouldn't be ridden until completely healed. The bandage needs to be changed about once every week to ten days, only more often if it gets wet or otherwise contaminated. The idea is to keep the wound clean, moist, stable and with enough pressure to retard further formation. If you stick to the program before the proud flesh matures and hardens, you should have good results. Once the excessive tissue has been resected, it's possible for you to do the bandage changes if the mare will allow you to handle her leg (it's not painful). You might ask the vet to leave some sedation that you can give IM or squirt into her mouth, +/- some additional help of a twitch or lip chain. If not, you'll have to get the vet to come do it under sedation. Good luck. Susan Garlinghouse, DVM, MS -----Original Message----- From: ridecamp-owner@xxxxxxxxxxxxxxxxx [mailto:ridecamp-owner@xxxxxxxxxxxxxxxxx] On Behalf Of spiritwood@xxxxxxxxx Sent: Sunday, July 18, 2004 7:32 AM To: ridecamp@xxxxxxxxxxxxx Subject: [RC] the healing process and proud flesh Hi, I am looking for some helpful advice on the best way to help a slow healing deep cut wound on the front of a rear ankle. For background, this mare cut the front of her ankle the last weekend in June. Vet came out and stitched it up on both sides but couldn't do the middle as a piece of skin was missing. Wound is right over the ankle where it bends on the front. Well, for 5 days horse got SMZ antibiotics and ankle looked good. WHen the medicine was finished, things started to go bad. We were able to keep the wound wrapped and clean but it seemed to be oozing and looked like it was starting to swell. After another day or so, ankle was visibly swollen and vet was called out to recheck it. By the time vet came out ankle has swollen enough to have popped most of the stitches out. Now horse(mare, need I say more), was having no more of all this messing with her now very sore leg. We were able to remove the rest of the stitches, hose out the wound and squirt betadine in the general direction of her now kicking foot, but are no longer able to wrap the leg as she has had enough! Vet did put her back on the SMZ for 10 days this time, with injectable Gentamycin once daily for 5 days which the horse doesn't mind. Now we are on the last day of the SMZ and the leg wound does seem to be healing from the inside out but very slowly. Mare has been kept in since we couldn't wrap her anymore, with twice daily hosing of wound and betadine, now followed up by some Wonder dust powder to help keep things dry and hopefully prevent some of the proud flesh. Flies don't seem to be bothering the leg either. Now I am trying to figure out the best way to manage this horse. My questions are" Would it be all right to turn this horse back out on pasture when its not muddy since she does allow us to hose and clean the wound daily! What is the best way to continue treatment and help prevent or limit the amount of proud flesh? What is the best product to use on the still open area that will probably take some time to completly heal shut? Should I ask the vet(new grad) for any additional antibiotics since the wound is still open? Help, my daughter is driving me nuts as this is her endurance horse who has done one very tough 50 and now is so out of shape and continuing to loose weight as she is missing out on most of the grass since she is still staying in the stall. Becky and Rave (a very opinionated mare) -------------------------------------------------------------------- mail2web - Check your email from the web at http://mail2web.com/ . =-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=- Ridecamp is a service of Endurance Net, http://www.endurance.net. Information, Policy, Disclaimer: http://www.endurance.net/Ridecamp Subscribe/Unsubscribe http://www.endurance.net/ridecamp/logon.asp Ride Long and Ride Safe!! =-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=- =-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-=-= Ridecamp is a service of Endurance Net, http://www.endurance.net. 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