Nonhealing wounds are a particular concern in horses because of the relative tension of the skin and lack of underlying soft tissues on the lower limbs. Thus, any wound at or below the carpus or tarsus is immediately problematic because of difficulties ensuring primary closure of wounds combined with a propensity to produce exuberant granulation tissue ('proud flesh'). There are also other problem areas to consider, such as wounds over joints or in areas of high motion. In addition, a chronic nonhealing wound should be worked up as a clinical problem, with multiple differentials such as tumour formation, and underlying foreign body or open synovial structure.
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