I noticed my 6 month old Silkie hen Nora limping one morning so I picked her up to assess her foot. Foot looked fine, but then I noticed staining on the underside of her wing. I lifted her wing and she had a giant wound.
Here is the wound on the day I noticed it:
I'm a nurse, so when I saw this my first thought was to put her down, especially because she's a bantam and this is a large wound relative to her size. But aside from limping, she was doing fine otherwise. So I brought her inside for a 24 hour observation and she didn't even seem to notice it. The wound had an odor and had "baby" maggots. I researched wound care on BYC for 2 days and did the following:
1. Flushed the wound with equal parts hydrogen peroxide and water to cleanse the wound and flush the maggots out.
2. Lavage of betadine watered down to the color of iced tea over the wound. Pat dry.
3. Sprayed Vetericyn gel over the wound.
4. Repeated this twice a day for 2 days.
On day two, I took her outside into the sunlight and got a better look. The eschar had softened and was starting to crack. I sterilized a pair of sharp scissors and started to debride the large chunks of necrotic tissue to see how she would tolerate it. To my surprise, she did exceedingly well and I even got a little bit of blood beneath the area of the largest piece of eschar, which was reassuring that we could potentially find some viable tissue beneath the necrosis. I cleansed the wound again as listed above. I used hydrogen peroxide again because I still didn't have any visible healthy tissue, and I saw more baby maggots.
On day three, I took her outside again and the eschar had cracked further. I saw what appeared to be fat and maybe (just maybe!) some pink/red tissue under there. However, there were more baby maggots. I slowly and carefully started to debride the wound further and after working for about half an hour, this is what I had (poor lighting, taken in the shade):
This time when I did wound care, I did:
1. Warm sterile water flush over the wound.
2. Betadine solution over the wound. Pat dry.
3. Vetericyn gel over the wound.
The tissue around the wound is also not viable but obviously I was not going to put her through too much at one time. I have seen the maggots in the top right corner over the leathery grey skin as well as in the bottom right corner where I wound up removing more feathers than I had in that picture.
I went to TSC and got Penicillin G Procaine thanks to the advice on this forum and administered a 1/4cc into her breast muscle just now. I also took this photo of how it is looking about 4 hours after the larger debridement this morning (lighting from bathroom window):
She is still eating, drinking, and pooping. Her poops are solid, not runny (so far, just started abx). I have supplemented her water with electrolytes and did the first of four daily IM injections of penicillin this afternoon. She is in a box in my bathroom. I am keeping her shavings clean, she pecks on half an apple during the day, and I even gave her a mirror to preen in (since I know I'd get bored being in that box 24/7). She was purring contentedly yesterday morning while I was getting ready for work so she does not seem to be suffering any systemic effects of the wound. If she began to display symptoms otherwise, I would do the humane thing for her.
So, my question to you guys is: What else can I do? Infection is my first concern at this point, followed by the maggots, and then tackling what to do with the rest of that skin surrounding the wound. Any and all suggestions are welcomed and appreciated!