(over­gran­u­la­tion)

EQUUS - - Prevention -

Def­i­ni­tion: over­growth of gran­u­la­tion tis­sue that rises over the edges of a wound, mak­ing heal­ing im­pos­si­ble Causes: Proud flesh is more likely to de­velop in

wounds to the lower limbs, wounds that re­main con­tam­i­nated with for­eign mat­ter, and those in more mo­bile ar­eas. Signs: The gran­u­la­tion tis­sue—which fills in the deeper por­tion of a wound that pen­e­trates all the way through the skin—will take on a lumpy, red­dish-yel­low, rub­bery ap­pear­ance. If in­fec­tion is pres-

ent, it may ex­ude flu­ids and have a nox­ious odor. Di­ag­no­sis: X-rays or ul­tra­sound may be used to look for dam­aged bone or em­bed­ded for­eign mat­ter. Testing may be nec­es­sary to dis­tin­guish proud flesh from sar­coids and var­i­ous types of in­fec­tions that can cre­ate sim­i­lar-look­ing le­sions in open wounds.

Treat­ment: Sur­gi­cal re­moval of the ex­cess growth is the pri­mary treat­ment for proud flesh. For more mod­er­ate cases, a top­i­cal cor­ti­cos­teroid may shrink the tis­sue enough to al­low proper heal­ing. The leg may be placed in a splint or case to keep it still while heal­ing pro­gresses. Skin grafts may be used for larger wounds.

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