Re: Proud Flesh - Again!

[CMKSAGEHIL@aol.com]

Gotta comment on the proud flesh issue.

First of all, I treat ALL injuries below the knee and hock as potential proud
flesh injuries, and I find that is far better to prevent proud flesh than to
have to deal with it later.

I shy away from steroids (such as Panalog) entirely--they DO inhibit proud
flesh, but they also inhibit the body's immune defenses, and that to me is not
a rational thing to do to an open wound.  I also don't like to use
nitrofurazone products, as they actually enhance the growth of granulation
tissue.

The protocol that I have found to work best is to use substances that are
slightly caustic and that inhibit granulation tissue without hindering the
local immune response to infection.  There are several commercial preparations
that do this, but about the best thing I have found is a mixture of powdered
alum and white vinegar.  These substances not only inhibit proud flesh, but
also inhibit bacterial growth.  I start right off with these products, even
when the wound is fresh, unless it is unusually deep.  I put a liberal amount
of the alum/vinegar mix on the wound, put a gauze or a Telfa over it, and wrap
the whole thing.  I change it daily for the first couple of days, but after
that, I put duct tape over the entire wrap and only change it every 5 or 6
days or so.  Some vets have had good success putting bad foot wounds in casts,
but I have also seen some of these go awry with pressure sores that rival the
original wound, so I have shied away from them.  Leaving the wrap in place for
several days has the same effect, though.  The wound will stink so bad that
you just about have to wear a clothespin on your nose to change the wrap, but
somehow marinating in its own juices seems to help, and I have had the best
luck by using at least some version of this protocol.  Needless to say, doing
horse practice in cattle country with plenty of barbed wire, this is probably
the most common sort of wound I have had to deal with in all my years of
practice.

Heidi Smith, DVM--Sagehill Arabians (Oregon)