Proud flesh is an excessive growth of granulation tissue that has the appearance of cauliflower.
It usually develops over an open wound, and most often occurs in areas of excessive tension and motion. These distal areas mainly are comprised of bone, ligaments, and tendons, and lacks underlying muscle. This anatomy causes the skin surface to be tense, which increases the risk of proud flesh because of the difficulty for skin to grow back over a wound. Proud flesh can become a problem when primary closure is not an option, and the skin has to heal through second intention healing. Second intention healing is when the skin has to heal first by granulation tissue forming over the wound, then the skin grows over the granulation tissue.