(overgranulation)

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.