Low leg wound and proud flesh

[JK-min]

Long story short- My pony had a pretty nasty wound on her leg. Infection quickly spread up the entire of her lower leg and the vet was called. Whilst waiting for the vet her leg was cleaned and dressed just to tie her over until the vet got there. The vet came, was satisfied that she hadn’t effected the joint but worried about ligament damage and confirmed infection. 5 days of antibiotics and Danilon and was advised to change dressing every other day.

Over this period the wound did weep but no smell and was reassured this was normal. The vet came the following week and was happy ligament wasn’t damaged and that her flesh had come back and all that was to happen next was the skin to come over. Advised to continue to dress but only needed changing once a week if it didn’t move- the pressure they said was to prevent proud flesh.

Week passed and I’ve redressed. She has proud flesh. She then fell and reopened the wound underneath the proud flesh. It was a horrific experience and I called the vet straight out. Vet said we was back at stage one with an open wound and back to changing every other day and once that has healed the proud flesh will need cutting off. She’s back on antibiotics and another anti inflammatory that I don’t actually know the name off.

Could I please have your experiences of lower leg wounds, proud flesh and how you would handle them? How often you would redress, how you would clean, would you put anything on it (creams etc- I haven’t as I was advised against it), when you think is a good time in the healing process to stop the dressing?

TIA- and sorry for the long ‘short’ story!

 

[be positive]

All injuries are different and heal in many variations, but I would be rather concerned about the advice given to leave any dressing for a week without changing it that is something that feels very wrong to me, most injuries I have deal with have healed with minimum, if any, proud flesh but from memory all have had some form of cream/ meds applied depending on what was needed.
The only 1 I remember having required proud flesh removing surgically was one treated by a clients vet that was left with a dressing on too long, in my view, it was a real mess when removed and the client changed vets to complete treatment.

I have used manuka honey successfully on wounds but there are many options available, I would suspect that yours may have been best cleaned up and stitched after it reopened but without seeing it that may not have been possible, surgical wounds tend to heal better and sometimes it can be worth doing more rather than less to speed up the healing process and get a better end result.

 

[Elf On A Shelf]

Unless the horse was casted to prevent any movement of a joint no dressing should be left on longer than 2 days!

Our usual procedure is:
Day 1 - clean with hibiscrub, stable bandage with intrasite over the wound and melonin.
Days 2&3 - clean with warm salt water tgen bandage as day 1.
Day 4 onwards - clean with warm salt water then put manuka honey on the wound. Only bandage if the leg is still swelling.

Where abouts is the injury? Fetlock or higher up? What type of injury? Just a skin cut or has it pulled the skin away in a flap? Do you have pics of it?

As for proud flesh they don't make it any more but some vets still have it in stock - vulcatan gel. Copper sulphate does a good job too but your horse may hate you for that.

 

[JK-min]

Everyone is in complete shock at the week advice I was given. I never want to go against the vet, but after everything I’ve read and everyone I’ve spoken to I can’t believe that advice or instruction so to speak was given because it actually defeats the object of every reason he was telling me it still needed dressing.

I will attach some photos. The ones where she cut her wound open under the proudflesh are pretty grim so apologies in advance!

 

[JK-min]

This is where it all started and how she was brought from the field. Picture doesn’t do it justice it appeared so deep.

 

[JK-min]

First change, weepy but come on leaps and bounds. As you can see swelling massively down.

 

[JK-min]

The change before the vet came. Vet was pleased and this is when he said it was only bandaged to prevent proud flesh..

 

[JK-min]

Photo for last message, for some reason it didn’t upload

 

[JK-min]

Leg unwrapped after lengthy time advised and proud flesh found, she then have a fall and cut it back open in and underneath the proud flesh and back at stage one.
This stage not only sent me into a melt down because of the blood but it has broken my heart and this is where I’m now clutching at straws questioning advice and seeing how quick others have healed. I’ve had help dressing I know the dressings are spot on with the woman who helps me but I just want her right it’s a shame summer and she’s spending it watching her friends in the field from her window. She’s only 4 ?

 

[AandK]

I posted on another thread about my 7yo's cut and how he had some proud flesh. I got the vet to take a look as I thought it might need trimming, but she said just to leave it open and the air getting to it should shrink it back and it did. I will say that it did bleed a lot the first few days, as it was just on the inside of his foot/pasturn and I think he kept catching it.

 

[JK-min]

Dressing changed today. Proud flesh is no longer apparent But it’s a deep red, sore and still open and bleeding when she moves :-( change again over weekend then vet back early next week.

 

[Regandal]

I used Neem oil on a nasty chest laceration, nigh on impossible to dress. It wept for a few days, then healed quite quickly.
Neem oil doesn’t sting or harm raw flesh, is anti microbial, fungal etc.
Fabulous stuff, apart from the smell.

 

[JK-min]

I have the vet back out Wednesday. I feel so stressed and like I’m not progressing with it. It’s such a shame, she’s only 4

 

[brighteyes]

It is right on a joint and the location means it's vulnerable to reopening. Proud flesh is a nightmare and the reaction, usually, to injury on non-fleshy areas. My TB (i'd only had him 5 blasted minutes) trod on his coronet band and made a proper mess. Wasn't ever lame but the wound developed proud flesh and reopened regularly before finally fully 'crusting over. Each time it is knocked, it bleeds profusely but there is no pain. His hoof wall developed a ridge below the injury. I kept it clean, bandaged hard for the initial stages but then left it open. I washed it regularly with Povidone and dressed it with Manuka honey. It is invisible 12 months on. Granted yours is larger and higher up, but really I think it is still early days. Vets can cut it back, but I think that is a process done later. Mine also got much worse before it got better!

 

[JK-min]

Brighteyes that’s exactly the problem, it couldn’t be in a worse place for movement. The problem is when she’s opened the proud flesh Up she’s also reopened the wound it’s gone quite deep so took plenty steps backwards.

I have been warned that it can be a long vicious circle for a while with proud flesh.

Thankyou all x

 

[Henry02]

I did find some cream ages ago that was meant to help with reduction of proud flesh, it was an American one. Can’t remember the name of in though

 

[JK-min]

Well, always trust your instincts!

When she had the second injury I really didnt feel it was healing well and really didnt think it appeared right around the joint so I called the vet back out (a different vet) and thank god I did. She has cut her extensor tendon in half. The poor girl has been stood with a cut tendon for a week. She is currently in Leahurst and had surgery yesterday to fix. All went well just pray for a good recovery which they are expecting, their biggest worry was her going under GA but she was fine. My heart is broken for her but she has been amazing when she must have been in so much pain. Thank god I called another vet out because were still in uncertain times but it would have never got better if I took the previous vets advice.

Thanks everyone- oh and theyve cut the proud flesh off in surgery. So I neednt worry about it anymore for the time being!

 

[Errin Paddywack]

Thank goodness for your gut instinct and that the second vet was on the ball. Everything crossed now that she makes a full recovery.

 

[Red-1]

Wow, that was unexpected, especially considering the second photo where the swelling was right down.

Hopefully it will heal well, I think prospects are much better for an extensor tendon, and at least the proud flesh has been sorted.

 

[JK-min]

She has cut it on the occasion she had fallen, so we have been very unlucky as it was not originally as bad.

Yes vets was open with me and said if it was a tendon at the back, there wouldnt really be much hope for her. All going well (or as well as it can) so far. Fingers crossed because shes amazing. Just wish I could see her as I cant go to Leahurst to visit with this COVID business, so thats atleast 2 weeks without her!

 

[Jeni the dragon]

So glad you followed your instincts! Hoping for a speedy recovery!

 

[Gloi]

Goodness me. Well she'll get the best care at Leahurst. Good luck.

 

[JK-min]

They’ve rang again today, she’s super settled not needed any sedation and already used to and happy to have the cast on. So all sounding good so far

thanks everyone x