Platelet-Rich Fibrin for Horse Wounds: Does PRF Speed Healing and Reduce Proud Flesh?

By Dr Duncan Houston

Lower-limb wounds are some of the most frustrating injuries encountered in horses. A relatively small laceration can take weeks or months to close, particularly when movement, contamination, tissue loss or exuberant granulation tissue interfere with healing.

Platelet-rich fibrin, usually shortened to PRF, is increasingly being discussed as a regenerative treatment for these difficult wounds. It is prepared from blood and creates a fibrin scaffold containing platelets, leukocytes and biological signalling proteins.

The science is promising, but PRF is not wound-healing wizardry in a centrifuge. It may support repair in selected cases, but only after the wound has been properly explored, cleaned, debrided and assessed for deeper damage.

Quick Answer

Platelet-rich fibrin may help selected horse wounds by providing a temporary fibrin scaffold and biological signals that support fibroblast activity, epithelialisation and tissue organisation.

However, most direct skin-wound evidence comes from laboratory studies and experimental wounds in donkeys. Controlled clinical evidence in horses with naturally occurring traumatic wounds remains limited. PRF should therefore be considered an adjunct to good wound management, not a substitute for debridement, infection control, appropriate bandaging, movement control or surgical treatment. (DOI.org)

What Is Platelet-Rich Fibrin?

Platelet-rich fibrin is a blood-derived biological scaffold.

Blood is collected from the horse and centrifuged using a specific protocol. Because PRF is usually prepared without an anticoagulant, clotting begins during processing and produces a fibrin matrix containing platelets, leukocytes and plasma-derived proteins.

The resulting material may be used as:

• A soft clot

• A compressed membrane

• A gel-like preparation

• A component of another biological scaffold

The fibrin provides a physical structure through which cells can migrate. The platelets and leukocytes release growth factors, cytokines and other proteins involved in inflammation, tissue formation, angiogenesis and remodelling.

Equine laboratory studies have shown that PRF can release transforming growth factor beta-1 and insulin-like growth factor-I over approximately two weeks. Other equine work has demonstrated sustained cytokine and growth-factor release from PRF clots for up to 21 days under laboratory conditions. This provides a plausible biological reason for using PRF as a wound-healing scaffold, but laboratory release does not automatically guarantee faster healing in a real traumatic wound. (PubMed)

Is PRF Always Made From the Horse’s Own Blood?

PRF used clinically is commonly autologous, meaning it is made from the same horse that will receive it.

This reduces concerns about immune incompatibility and disease transmission. However, autologous does not mean risk-free. Contamination can still occur during collection, centrifugation, handling or application.

Some experimental studies have used allogeneic PRF obtained from another animal. Those findings cannot automatically be assumed to apply to every autologous clinical protocol.

What Is the Difference Between PRF and PRP?

PRF and platelet-rich plasma are related, but they are not interchangeable.

Feature	Platelet-Rich Plasma	Platelet-Rich Fibrin
Common abbreviation	PRP	PRF
Preparation	Usually prepared with an anticoagulant before platelets are concentrated	Usually prepared without an anticoagulant, allowing a natural fibrin clot to form
Final form	Commonly a liquid, although it can be activated into a gel	Usually a clot, membrane or fibrin-rich gel
Physical behaviour	May be injected, sprayed or converted into a gel	Can provide a more stable scaffold that remains in contact with the wound
Biological release	Often produces relatively early release after activation	May produce more gradual release from the fibrin matrix
Standardisation	Platelet and leukocyte concentrations vary substantially between systems	Cell distribution, fibrin structure and growth-factor release also vary between protocols

PRP is not necessarily “too liquid” for wounds. Activated PRP gel has been studied in equine skin wounds and may remain on the wound surface. In one early experimental study involving lower-limb wounds in a horse, PRP gel was associated with earlier epithelial differentiation and more organised collagen, although the study did not establish that PRP reliably prevents proud flesh or shortens healing in a wider clinical population. (PubMed)

PRF should not be described simply as a better version of PRP. The two products have different characteristics, and neither has one universally standardised veterinary formulation.

Why Are Lower-Limb Horse Wounds So Difficult to Heal?

The problem is more complicated than simply saying the lower limb has poor blood supply.

Distal-limb wounds have:

• Very little spare skin available for closure

• Limited soft-tissue coverage over tendons, joints and bone

• Constant movement during standing and walking

• Frequent exposure to dirt, bedding and faecal contamination

• Greater difficulty contracting than many body wounds

• A tendency towards prolonged inflammation and fibroproliferation

• A higher risk of exuberant granulation tissue

Equine limb wounds heal more slowly than comparable body wounds and are more likely to develop abnormal granulation tissue. Research suggests that the inflammatory response within distal-limb wounds does not resolve normally, leaving some wounds trapped in the proliferative stage of healing. (PubMed)

This is why a small wound over the fetlock can be more clinically important than a much larger but superficial wound over the neck or body.

What Is Proud Flesh?

Healthy granulation tissue is necessary for wound healing.

It fills the tissue defect, supports new blood vessels and provides a surface over which skin cells can migrate. Normal granulation tissue is generally pink to red, moist, relatively smooth and level with or slightly below the surrounding skin edges.

Proud flesh, or exuberant granulation tissue, occurs when granulation tissue continues growing above the level of the surrounding skin.

Once this happens, epithelial cells cannot migrate effectively across the wound. The wound may remain open, bleed repeatedly when traumatised and become caught in a cycle of inflammation, irritation and further granulation.

Research examining equine exuberant granulation tissue has found persistent populations of inflammatory and fibrosis-associated macrophages, supporting the view that these wounds become arrested in the proliferative phase rather than progressing normally into remodelling. (PubMed)

What Increases the Risk of Proud Flesh?

Contributing factors can include:

• Distal-limb location

• Repeated movement across the wound

• Infection or bacterial biofilm

• Retained foreign material

• Devitalised tissue

• Exposed or damaged bone

• Repeated trauma from dressings

• Excessively wet or occlusive wound conditions

• Delayed epithelialisation

• Inappropriate topical products

In one experimental equine study, all bandaged distal-limb wounds developed exuberant granulation tissue while none of the unbandaged wounds did. This does not mean that every horse wound should be left uncovered. Early bandaging may be essential for controlling haemorrhage, contamination, swelling and tissue movement. It does show that prolonged occlusive bandaging must have a clear purpose and should be regularly reassessed. (PubMed)

How Might PRF Help a Horse Wound?

PRF has several characteristics that could theoretically support healing.

It Provides a Fibrin Scaffold

Fibrin creates a temporary matrix through which fibroblasts, endothelial cells and other repair cells can move.

This can be particularly useful in a wound with a tissue deficit, provided that the underlying wound bed is viable and adequately debrided.

It Delivers Platelet-Derived Signals

Platelets contain biological mediators involved in:

• Cell migration

• Fibroblast activation

• Angiogenesis

• Collagen production

• Extracellular matrix formation

• Epithelial repair

These signals help coordinate normal wound healing, although higher concentrations do not necessarily guarantee a better clinical result.

It May Maintain Contact With the Wound

A PRF membrane or clot can remain in contact with a wound more easily than an unactivated liquid preparation.

This may allow PRF to function as a temporary biological contact layer beneath a suitable dressing.

It May Release Biological Signals Gradually

Equine PRF clots have demonstrated sustained growth-factor release in laboratory conditions rather than releasing everything immediately. This is one of the main theoretical advantages of the fibrin matrix. (PubMed)

What Does the Evidence Actually Show?

This is where the original claims need to be interpreted cautiously.

Equine Fibroblast Research

A 2025 laboratory study investigated advanced platelet-rich fibrin plus, or A-PRF+, using primary equine fibroblasts.

A-PRF+ increased fibroblast metabolic activity, proliferation, cell-cycle activity and migration in a laboratory scratch-wound model. Treated fibroblasts closed the artificial gap more effectively than untreated cells over 24 hours. Proteomic testing also identified changes in pathways associated with extracellular matrix remodelling and tissue regeneration. (DOI.org)

This supports a biological mechanism for PRF.

It does not prove that PRF will close a contaminated fetlock wound faster, prevent proud flesh or restore a horse to work.

Cells in a dish do not face wound motion, devitalised tissue, flies, bacterial contamination, exposed tendon or synovial infection.

Experimental Distal-Limb Wounds in Donkeys

A 2019 study created full-thickness distal-limb wounds in 12 donkeys. PRF-treated wounds reportedly closed in approximately 36 days compared with approximately 48.5 days for untreated wounds. Epithelialisation and contraction began earlier, and the granulation tissue was described as smoother and more regular. (AGRIS)

This is encouraging, but the wounds were standardised experimental defects in healthy donkeys. They were not naturally occurring horse wounds with variable contamination, crushing, tissue loss or damage to deeper structures.

PRF Combined With a Biological Scaffold

A separate 2023 donkey study combined PRF with decellularised bovine pericardium. Treated wounds healed in approximately 61 days compared with approximately 90 days for control wounds, with improved histological and gene-expression findings. (PubMed)

Because PRF was combined with another scaffold, the improvement cannot be attributed to PRF alone.

Preliminary Clinical Horse Evidence

A small preliminary clinical study involving nine naturally occurring equine distal-limb wounds compared conventional treatment, laser therapy and PRF.

The laser-treated wounds had a higher healing rate, while healing rates in the PRF and conventional groups were similar. The study was small and involved highly variable wounds, but it demonstrates why PRF should not yet be presented as a reliably superior treatment in horses. (Repositório)

PRP Wound Research in Horses

Activated PRP gel has demonstrated earlier epithelial differentiation and more organised collagen in an experimental equine wound model. However, the study was extremely small and assessed tissue characteristics rather than proving a consistent reduction in total healing time, infection or proud flesh across a clinical population. (PubMed)

Does PRF Prevent Proud Flesh?

There is currently insufficient direct clinical evidence to say that PRF reliably prevents or treats proud flesh in horses.

The donkey studies described earlier epithelialisation and smoother granulation tissue, which could theoretically reduce the period during which exuberant granulation develops. However, this is not the same as proving that PRF prevents proud flesh in real horse wounds.

There is also an important biological nuance.

A-PRF+ stimulates equine fibroblast proliferation and migration. Proud flesh is itself an excessive fibroproliferative response. It is therefore not sensible to assume that stimulating more tissue growth will automatically produce less exuberant granulation.

My clinical interpretation is that PRF may help when it promotes organised repair and earlier epithelial coverage, but its timing and the condition of the wound bed are likely to matter. This is a biologically supported inference, not a proven clinical rule. (DOI.org)

Once proud flesh already projects above the skin edges, PRF is unlikely to flatten it magically. Established exuberant granulation tissue may need veterinary excision, correction of motion or infection, a change in bandaging strategy and reassessment of the original diagnosis.

Can PRF Be Used on an Infected Wound?

PRF should not be treated as an alternative to infection management.

A contaminated wound may need:

• Thorough exploration

• Lavage

• Removal of devitalised tissue

• Removal of foreign material

• Drainage

• Culture or biopsy

• Systemic or local antimicrobial treatment

• Imaging for sequestra or osteomyelitis

• Investigation of a nearby joint or tendon sheath

Biofilm has been identified in chronic equine wounds and may help explain why some wounds continue draining or fail to respond to routine treatment. One study found histological evidence of biofilm in 8 of 13 equine wounds examined. (PubMed)

Placing a fibrin membrane over retained necrotic tissue, a foreign body or an untreated deep infection does not fix the underlying problem. It may merely dress it up in an expensive little biological blanket.

PRF could potentially be considered later, once the wound has been adequately debrided and infection is controlled.

Which Horse Wounds Might Benefit From PRF?

Possible candidates may include:

• Selected distal-limb wounds healing by second intention

• Large wounds with a clean, viable granulation bed

• Wounds showing delayed epithelialisation after deeper problems have been excluded

• Selected surgical defects

• Wounds being prepared for skin grafting

• Chronic wounds that have been fully reassessed for infection, foreign material and bone involvement

• Cases where conventional wound management has produced inadequate progress

The strongest candidate is not simply “a difficult wound.”

It is a difficult wound with:

1. A confirmed diagnosis

2. A viable and adequately debrided wound bed

3. No untreated synovial involvement

4. Controlled contamination

5. An appropriate bandaging and movement plan

6. Objective monitoring of healing

When Is PRF Unlikely to Be the First Priority?

PRF is not the first priority when the horse has:

• Active haemorrhage

• A fresh wound that may still be surgically closed

• A deep puncture

• Suspected penetration of a joint, bursa or tendon sheath

• Exposed or damaged tendon

• Exposed bone

• Retained foreign material

• Necrotic tissue

• Severe lameness

• Rapidly spreading swelling

• Fever or systemic illness

• A wound requiring stabilisation or surgical reconstruction

In these cases, diagnosis and definitive treatment come first.

The regenerative product is the garnish, not the meal.

Not Every Non-Healing Wound Is Proud Flesh

A raised, bleeding or chronically draining wound should not automatically be labelled proud flesh.

Important rule-outs include:

• Chronic bacterial infection or biofilm

• Retained wood, wire or other foreign material

• Bone sequestrum

• Osteomyelitis

• Synovial communication

• Fungal or parasitic granuloma

• Habronemiasis

• Sarcoid or another tumour

• Repeated mechanical trauma

• An unstable wound over a moving joint

• Contact irritation from topical products

Biopsy, radiography, ultrasonography, culture or synovial sampling may be needed before another treatment is applied.

In horses with wounds near a joint or tendon sheath, normal plain radiographs do not reliably rule out synovial penetration. A recent study found that plain radiography had limited sensitivity, meaning the absence of radiographic evidence could not safely exclude communication with a synovial structure. (PubMed)

Practical Wound Risk Framework

Lower Risk

The wound is:

• Superficial

• Clean

• Clearly limited to skin

• Away from joints and tendon sheaths

• Not causing significant lameness

• Beginning to contract and epithelialise normally

Action: Routine veterinary wound care may be sufficient. PRF is unlikely to be necessary.

Moderate Risk

The wound:

• Is on the distal limb

• Cannot be sutured

• Has healthy granulation tissue

• Is healing by second intention

• Is progressing, but slowly

• Has no evidence of deep structural involvement

Action: Continue structured wound care. PRF may be discussed as an optional adjunct, but objective measurements should be used to determine whether it adds value.

High Risk

The wound:

• Has persisted for several weeks

• Repeatedly develops exuberant granulation tissue

• Has exposed tendon or bone

• Produces persistent discharge

• Has stopped contracting

• Has irregular or suspicious tissue

• Causes ongoing lameness

Action: Reinvestigate the reason for delayed healing before applying PRF. Imaging, biopsy, culture, debridement or referral may be more important than another topical therapy.

Critical

The horse has:

• A puncture or laceration near a joint or tendon sheath

• Severe or increasing lameness

• Rapidly increasing swelling

• Clear or straw-coloured fluid leaking from the wound

• Uncontrolled bleeding

• An exposed synovial structure

• Fever, depression or reduced appetite

• A deeply contaminated wound

• A wound involving the hoof or heel bulb

Action: Treat this as an emergency. PRF has no role until life-threatening and performance-threatening complications have been assessed and treated.

When Is a Horse Wound an Emergency?

Contact a veterinarian immediately when:

• Bleeding continues despite firm direct pressure

• The wound lies over or close to a joint, tendon sheath or bursa

• A deep puncture has entered the sole or frog

• Bone or tendon is visible

• The horse is markedly lame or will not bear weight

• The wound is heavily contaminated or contains foreign material

• There is sudden swelling around a joint or tendon sheath

• Fluid appears to be leaking from a synovial structure

• The horse develops fever, depression or worsening pain

• A flap or degloving injury is present

Early treatment matters.

In a study of digital flexor tendon-sheath lacerations, horses treated within 36 hours had a significantly better probability of returning to intended athletic use than horses treated later. Endoscopic treatment of contaminated and infected synovial structures can also identify foreign material, tendon damage and cartilage injury that may not be apparent from the surface wound. (PubMed)

Do not delay emergency assessment while searching for PRF, honey, laser therapy or the internet’s latest favourite potion.

How Is PRF Applied in Practice?

There is currently no single validated equine wound protocol covering every PRF system.

A typical veterinary process may involve:

1. Assessing the wound and deeper structures

2. Lavaging and debriding the wound

3. Controlling infection and haemorrhage

4. Collecting blood using an aseptic technique

5. Centrifuging it immediately using the selected PRF protocol

6. Isolating and preparing the fibrin clot or membrane

7. Placing the material onto an appropriate wound bed

8. Protecting it with a suitable contact layer and bandage

9. Reassessing the wound at planned intervals

Different centrifugation speeds, times, tube types, temperatures and devices produce PRF with different fibrin structures and cellular compositions. A 2024 equine study demonstrated that A-PRF+ can be produced in field conditions, but also highlighted the importance of protocol and environmental conditions. (ScienceDirect)

This is why PRF is not an appropriate do-it-yourself procedure.

Blood from the same horse does not remain a sterile biological dressing by sheer optimism once it has passed through unsuitable tubes, equipment and hands.

How Many PRF Treatments Does a Horse Need?

There is no universally proven number.

Experimental protocols have ranged from a single application to repeated weekly treatments. The appropriate frequency may depend on:

• Wound size and depth

• Exudate production

• Whether the PRF remains in contact with the wound

• The specific PRF preparation

• Bandage-change frequency

• The condition of the granulation bed

• Whether measurable progress is occurring

• Cost and practicality

Repeated treatment should not continue automatically because the wound still looks dramatic.

The decision should be based on objective improvement, including wound area, epithelial margin, contraction, granulation height, discharge and comfort.

What Should You Do Right Now With a New Horse Wound?

1. Keep the Horse Still

Move the horse to a safe area and minimise unnecessary walking.

Do not repeatedly trot or circle a horse with a deep limb wound to “see how lame they are.”

2. Control Bleeding

Apply firm, continuous pressure using a clean dressing.

Do not repeatedly lift the dressing every few seconds to check whether the bleeding has stopped. That politely removes the clot you were trying to create.

3. Protect the Wound

Cover the wound with a clean, non-adherent dressing if this can be done safely.

Do not apply powders, caustic chemicals or multiple coloured sprays before the veterinarian has assessed its depth.

4. Do Not Probe It

A small puncture may extend into a joint, tendon sheath, bursa or hoof structure.

Probing it at home can introduce contamination, damage tissue and make later diagnostic testing more difficult.

5. Call the Veterinarian

Same-day assessment is particularly important for lower-limb wounds, punctures, wounds near synovial structures and any injury causing substantial lameness.

6. Check Tetanus Protection

The horse’s tetanus vaccination history should be confirmed. Wounds provide a potential route of entry for Clostridium tetani, and additional protection may be required depending on vaccination history and wound type.

7. Discuss Regenerative Therapy Later

Once the important questions have been answered, you can discuss whether PRF, PRP, advanced dressings, skin grafting or another adjunct is appropriate.

How Should Healing Be Monitored?

Photographs alone can be misleading because camera angle and distance change how large a wound appears.

A better monitoring system includes:

• Photographs from the same position

• A ruler or measurement scale beside the wound

• Wound length and width

• Estimated wound area

• Height of granulation tissue relative to the skin edge

• Width of the new epithelial margin

• Amount and type of discharge

• Odour

• Limb swelling

• Lameness

• Pain during bandage changes

• Treatment and bandage-change dates

Contact the veterinarian if:

• Pain, swelling or discharge increases over 24 to 48 hours

• The wound suddenly enlarges

• Granulation tissue rises above the skin margins

• The epithelial border stops advancing

• Malodour develops

• The horse becomes more lame

• A firm area of exposed bone or persistent draining tract appears

• The wound repeatedly deteriorates after initially improving

Bandaging and Proud Flesh

Bandaging is neither universally good nor universally bad.

During the early stage, an appropriate bandage can:

• Control haemorrhage

• Reduce contamination

• Protect exposed tissue

• Limit swelling

• Reduce movement

• Maintain a suitable wound environment

Once a healthy granulation bed has formed, prolonged moist occlusion may encourage excessive granulation in some distal-limb wounds.

The plan may therefore need to change as the wound progresses. A dressing that was appropriate on day one may be counterproductive several weeks later.

Do not simply keep repeating the same bandage because the horse has not yet healed. Wounds are irritating like that. They change the assignment halfway through.

Are There Alternatives to PRF?

The most appropriate alternative depends on why the wound is failing.

Options may include:

• Further surgical debridement

• Removal of a foreign body or sequestrum

• A different dressing strategy

• Treatment of infection or biofilm

• Reduction of wound movement

• Surgical excision of exuberant granulation tissue

• Skin grafting

• PRP gel

• Selected biological scaffolds

• Reconstructive surgery

• Specialist referral

For large, healthy, granulating wounds, skin grafting may have stronger direct equine clinical evidence than PRF. In one study of 13 horses with large chronic limb wounds, a modified micrografting technique achieved high graft acceptance and substantially accelerated closure through both epithelialisation and contraction. (PubMed)

PRF may ultimately prove valuable alongside these treatments, but it should not delay a better-established intervention when time matters.

Common Mistakes With PRF and Equine Wound Care

Calling Every Raised Wound Proud Flesh

Persistent irregular tissue may represent infection, foreign-body reaction, parasitic disease or a tumour. A biopsy may be more useful than another wound cream.

Applying PRF Before Debridement

PRF cannot make dead tissue alive or remove material embedded in the wound.

Assuming PRF Treats Infection

PRF is not an antibiotic and does not replace lavage, debridement, drainage or appropriate antimicrobial treatment.

Keeping Every Wound Continuously Bandaged

Bandaging must have a defined purpose and should evolve with the stage of healing.

Trimming Proud Flesh at Home

Granulation tissue can bleed heavily, and an owner may accidentally damage the epithelial edge, tendon or another deeper structure. Excision should be planned and performed by a veterinarian.

Assuming Autologous Means Risk-Free

A product made from the horse’s own blood can still be contaminated, incorrectly prepared or applied to the wrong wound.

Continuing Because the Treatment Sounds Advanced

A treatment should earn its place through measurable improvement. A centrifuge and an impressive acronym do not overrule wound biology.

How Can Proud Flesh and Delayed Healing Be Reduced?

The best prevention strategy begins before proud flesh appears.

Focus on:

• Early veterinary assessment of distal-limb wounds

• Closing fresh wounds when appropriate

• Accurate assessment of joints and tendon sheaths

• Removal of devitalised tissue and foreign material

• Appropriate control of infection

• Reducing movement where possible

• Correct bandage selection and changing frequency

• Preventing repeated trauma

• Fly and environmental contamination control

• Maintaining tetanus vaccination

• Providing adequate nutrition and protein

• Monitoring systemic disease that may impair healing

• Measuring progress rather than relying on memory

The goal is not to make a wound produce as much tissue as possible.

The goal is to create the right amount of healthy granulation tissue, followed by contraction, epithelialisation and remodelling.

Frequently Asked Questions

Is platelet-rich fibrin the same as platelet-rich plasma?

No. PRP is usually a platelet-concentrated liquid that can be injected or activated into a gel. PRF forms a fibrin-rich clot or membrane containing platelets and often leukocytes. Preparation methods and biological-release patterns differ.

Can PRF remove proud flesh?

No. PRF does not physically remove established exuberant granulation tissue. Proud flesh projecting above the skin edges may require surgical excision and correction of infection, movement or bandaging factors.

Can PRF be placed on an infected horse wound?

It may be considered only after the wound has been properly assessed and infection is being controlled. PRF does not replace debridement, drainage, culture, antimicrobial treatment or investigation of deeper structures.

Does PRF guarantee faster wound healing?

No. Laboratory and donkey studies are encouraging, but direct controlled clinical evidence in naturally occurring horse wounds remains limited. Some wounds may benefit, while others may show little measurable improvement.

Is PRF safe for horses?

Autologous PRF is generally expected to have a low immunologic risk, but contamination, processing variability, inappropriate application and local inflammation remain possible. It should be prepared and applied using an aseptic veterinary protocol.

How often should PRF be applied?

There is no universal schedule. Frequency depends on the wound, preparation method, dressing strategy and response. Repeated treatment should be guided by objective wound measurements and veterinary reassessment.

Final Thoughts

Platelet-rich fibrin is one of the more interesting emerging tools in equine wound management.

It provides a biological scaffold, releases signalling proteins and stimulates equine fibroblast activity. Experimental donkey studies suggest that it can improve epithelialisation, contraction and total healing time under controlled conditions.

What it has not yet earned is the title of proven game-changer for traumatic horse wounds.

PRF does not replace wound exploration, debridement, infection control, appropriate closure, movement management or investigation of nearby joints and tendon sheaths. It also cannot be assumed to prevent proud flesh simply because it contains growth factors.

The best use of PRF is likely to be selective: the right wound, at the right stage, after the important underlying problems have been corrected, with objective monitoring to confirm that it is actually helping.

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ASK A VET™ can help you organise serial wound photographs, measurements, bandage changes, medications and recheck dates. Any deep, painful, draining or joint-adjacent wound still requires prompt hands-on veterinary examination.