Bear - 2015-06-23 7:22 PM You really won't accomlish much by wrapping. The edema is temporary and cosmetic, more than anything. In fact, wrapping it could reduce the blood supply.....think about it. If the horse is sound, etc...., I think you will be fine. Personally, the best and least expensive way to deal with this is to keep the surface "debrided" of pus, dead tissue, etc.... That way the wound will shrink up/ contract and skin will grow over the top of the beefy red/pink base. Good old elbow grease works well. I'd scrub it with a soft bristle brush, soap, and water. Surgical soap (ie: hibiclens or betadine) works well, but just about any soap will work. Antibiotics probably won't help....not even topical antibiotics. Hose the hell out of it....hydrotherapy. If you want to spray on some topical antiseptic, fine, but it really doesn't matter that much. I'd say do this a minimum of twice a day, but more is better. You will start to see that pink granulation tissue get beefier and red. That's good. If you keep this up you will see the rate of healing progress more rapidly. A lot of people swear by a lot of products for wounds, but honestly there's no substitute for elbow grease and a lot of water. The underwoods, vetericyn, etc.... Is fine, but definitely not mandatory, IMO. Good luck! You'll do fine.

Bear - 2015-06-24 2:30 PM I suppose I've had the typical amount of experience with wounds like this as anyone else, but what helps me is my understanding of the basic science of wound healing, after 35 years of experience with difficult wounds in humans, plus a pretty good background in immunology. There are all sorts of regimens and routines out there for dealing with wounds in horses, and the one thing they tend to have in common is the seemingly miraculous way they tend to heal, regardless of what you do. In some cases, it's because the treatment was masterful, while in others they healed in spite of what was done. There's always a tendency, I think, for people to make the management of these wounds more complicated than they need to be. "Proud flesh" is granulation tissue, which is vascularized fibrotic tissue that is poorly organized, but vital to the healing process, because it becomes more organized, histologically, over time. Scrubbing a wound does not mysteriously "stimulate" ugly proud flesh, actually. That's a myth. What it does do is accelerate healing by reducing the anmount of dead flesh and debris and bacteria. In fact, what actually happens in instances of proud flesh is that accelerated healing causes the granulation tissue to grow over the skin edges, and that in itself can impede the in growth of skin, which normally heals at a rate of approximately 1 mm a day. When the edges hit that "wall" of proud flesh, the rate of healing slows, while the "cauliflower" of granulation tissue piles up. The way you get around this is to either scrub the granulation tissue to keep it level, or excise it at the skin level. Granulation tissue can actually sometimes scooped away with a spoon, or you can do it sharply. The goal is to preserve that vascularized bed, while allowing the skin to grow over it. Granulation tissue is not innervated....they can't feel you scraping it away. Handling, scrubbing, and hosing the wound desensitizes the horse. At least that's been my experience. After a while, they pretty much treat you like a farrier. When you do debridement, the granulation tissue bleeds, sometimes a fair amount. Pressure for a few minutes, plus more hosing, will cause that to stop. That bleeding is a good sign. The reason people have problems with persistent proud flesh is because they just let it continue to build up.......trim it to skin level and you won't have this problem. There's no mystery here. Pressure with wrapping, etc, actually hinders oxygen supply to the wound. You can do it in situations where the wound gets very heavily contaminated, but just keep that in mind. Many "treatments" applied to these wounds actually kill normal healthy tissue because the acids and chemicals are toxic. You can try it, but just keep it in mind. They are not as effective as debridement.....elbow grease. Some people use steroids.....I don't think that's a good idea either, because steroids impair healing and actually cause skin atrophy. You want the new skin to be healthy....not atrophied. As to the issue of water.....the more the better. The notion of cold water or warm water somehow magically "stimulating" proud flesh in a bad way is a myth. Just keep the granulating bed at skin level so you don't get the cauliflower effect.