URGENT! Huge Cut, need HELP NOW! *PICS added

I notice blood on the ground, then on her foot, Her arm pit going down towards her foot is ripped open, about 4 inches long, skin is ripped open.

I can see her muscles and some fat, no major blood vessels are broken so she is not still bleeding, but there is a gaping hole.

I cleaned her with diluted soapy water and doused her with iodine.

Is this her air sac?

THe skin is not very close together because of length of wound.
Do I need to sew her skin back together?
The skin is very thin and tissue like in this area.

Please advise if I need to stitch or will this heal if I keep her clean??

I have no idea how this happend, it looks like very fresh blood and I did not hear any commotion.

Thank you!!

do you have any first aid tape or even band-aids you could pull the edges of the skin together & secure w/ tape or bandaid? I'd try that before attempting to suture. Put some triple antibiotic ointment in the wound if you have it, too.

I would also do a thorough check in the coop & run; perhaps there may be a nail/screw sticking out, or could she possibly have tried to fly over a fence and got caught?

Do you have roosters? If you do, get them and file off the spurs.

On the wound, cut feathers away from it so that they won't stick to it. clean it carefully with iodine thinned with water til it's the color of light iced tea. Pat dry. Dress the wound with neosporin and keep her up for two days. I wouldn't stitch the wound, but I would try to get some "butterfly" bandages from the drug store today and (after drying the wound and putting the antibiotic into the gash, not on the skin part) using those to lightly close the wound so that the skin can heal to itself. When you use the neosporin, be sure to slather it lightly on the wound AND under the skin where it's ripped - each place where you want it to join together.

Keep the bird up for two days to allow the wound to get leathery on top and to keep flies out of it. Flies can smell a wound for over a mile away and it only takes one fly to lay 300 maggot eggs. So keep her up just for two days at least. Then I'd keep her away from roosters for a while if you have any.

In the mean time, here's an article on treating wounds. Again I feel a good thorough five-to-six times cleaning with iodine mixed thin with water will treat this wound and all the rest won't be necessary except that listed above. But the info is there in case you need it in the middle of the night.

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WOUND CARE FOR POULTRY – by Nathalie Ross
(updated August 19, 2009)

Unfortunately, poultry and waterfowl fall prey to predators often as they are a vulnerable species. It’s not always possible for us to take our birds to a vet; sometimes we are forced to deal with the injuries immediately. Indeed, wounds should always be dealt with immediately to lessen the chances of infection. For those times when no vet is available, I’ve written this article. I hope that you find it helpful when help is needed.

This is my usual way of handling wound care in both poultry and waterfowl. It is a combination of personal experience, veterinary assisted care, veterinary advice, and research. I’ve used it successfully on some pretty extensive wounds, including wounds that were of large areas and no skin. Poultry and waterfowl are quite resilient and I feel it’s important to give the bird a fighting chance if they survived an attack.
Some wounds are more extensive than others. Sometimes wound care requires neither all of these steps nor all of the materials. I will leave it to the reader to determine how far to take the treatment. However, I do wish to say that the most important part of wound treatment would be the initial examination for wounds, and the cleansing. This makes the rest of the process much easier and more effective.

First, gather materials as needed:
VetWrap or similar self-adhesive wrap.
gauze wrapping type bandages or squares (depending on what you have to bandage)
non-stick pads (depending on what you have to wrap)
antibiotic ointment (neosporin, Swat for horses if you have flies around)
hydrogen peroxide (h202)
iodine
warm water
a needleless syringe - preferably a big one like 30 cc's, or baby’s ear syringe
suture material if you need it (this ideally should be left to a vet)
a small pair of scissors like cuticle scissors are helpful
large scissors
(duct tape in some cases)
a good safe blood clotting agent. I prefer Clotisol as it's not poisonous and clots IMMEDIATELY even in high blood situations. You can even use it inside of beaks. It's water based, lasts ages for a small bottle. Seriously - ages. You can pretty much only get it online, but it's a must-have for a cabinet. Once you use it, you won't go back.
q-tips
paper towels
clothes that can be stained

DECIDING WHETHER OR NOT TO TREAT BY YOUR SELF:
First, an important note: It would be ideal if, as poultry owners faced with an injured bird, that the bird be taken to a qualified veterinarian who can not only dress the wounds, access the damage, but also prescribe the correct antibiotics and follow up as necessary. This, first and foremost, is what I recommend for any wound situation that is more than minor. Please take that to heart.

If instead you decide to treat the wound yourself, here are some basic instructions on how to do so. Note that every wound, every case, is different. Use your common sense and imagination on determining when this protocol must be flexed to fit your situation.

PREPARATION:
First, examine the bird and find all wounds. Literally check every inch of the bird’s body as bird down hides puncture wounds VERY well. Where you find a wound, use your big and little scissors to trim feathers away from the area. Try to only take as many as could touch the wound, no more - they need feather protection and the feathers won't grow back until next molt. Also be careful, if wing feathers are near, not to cut the living flesh part inside feather quills.

If the wounds are under the wing, sometimes you can simply wrap the wing in a t-shirt to keep whatever touches the wing clean. Baby t-shirts would be great for this. Neck part at the top of the wing, fitted with a little duct tape on the cloth (not tight please) and just tie the other end of the t-shirt.

Make sure to look very carefully against the skin for puncture wounds. There might not be look, and puncture wounds are tricky and hard to find. Note the location and severity of all wounds.

CLEANSING:
In this step, the best advice I can give is “clean it like you mean it”! When you clean, do so as if you’ll only get one chance and you want it to last for the entirety of the bird’s convalescence. If you do a really good thorough job, it might just last that long! It should be - barring other factors (like bite germs).
Take your syringe or a baby’s ear syringe and fill with hydrogen peroxide (H202) slightly diluted with water. Use the syringe to vigorously clean the wound area including in the wounds. (Do not use H202 on skinned-type wounds or slick places where skin is off – skip to the iodine step.) You only use h202 the first time as it tends to burn tissues and keep them from healing if you continue. It’s great for bubbling out bits of dirt from inside the wound and “burning” (oxidizing) germs. Do this cleansing about three times per wound. At this step, putting the bird on top of paper towels or regular towels that you can ruin makes things easier – the H202 doesn’t run everywhere or make the bird too wet.

Follow up by rinsing out the H202 with a water/iodine mixture made to be just the color of slightly strong iced tea. You want it warm. Fill your same syringe that you used with the H202 and flush the wounds rather vigorously. I like to think of it as trying to hit someone with the jet of the cleansing solution if the person is standing 4 feet away from me.
Alternately, you can use a solution of Nolvasan cleanser and water – 1 part Nolvasan to 6 parts water.
At this time, if there are any pieces of flesh that need to be removed, remove them. This is where I use a q-tip dipped in a bottle-cap full of Clotisol (so you don't contaminate the original bottle).
Doing this on a table that's ok to stain is best. I've done this on my truck's tail gate as I can clean it afterwards. Place a lot of paper towels under the birds for these two cleansing phases to keep the drain-off from going everywhere.
Use another clean paper towel to dry the wound. You want to leave some iodine solution inside the wound - it doesn't have to be skin-dry. Just dry enough for some ointment to stick.
DRESSING:
Once the wound is well cleaned, then you'll want to dress it. I use Neosporin and q-tips most often for this job. If there are flies in the area at all, I will use Neosporin inside the wounds (ointment) and use Swat wound ointment for horses instead. (It has fly repellent that's safe for poultry in it.) I fill punctures with neosporin. If they're deep, I stick the top of the tube into the wound (and throw away the tube after I'm done with everything). Pack it. You usually want air in a wound, but puncture wounds can sometimes heal on top first and leave a pocket inside. The antibiotic ointment (not creme) is a little insurance against too much bacteria and thus abcesses.
If the wound is one that absolutely must be stitched, then pack it with the antibiotic ointment. If you're using a fly-proof ointment, wipe the wound and then use the fly-proof on top. Otherwise just wipe slightly so there's a little antibiotic ointment on the important top part of the wound. You don't want to stray too far from just the wound, keep the bird dry.
On closing wounds with sutures: puncture wounds shouldn't be sutured. Bad bacteria love a place where there's no oxygen. Suturing closes the wound and encourages festering within. As much air as you can get to a wound, the better, except that the interior of punctures should have some antibacterial action going on.
I've had some serious wounds in my flock before. The only time I've sutured was when a very large flap of skin was torn from the front of a neck (read as 3 inches by 10 inch flap). Another recent case involves a possible rather large hole in a crop which, should it leak food, should be sutured. Otherwise try to leave things open. Poultry can re-grow an amazing amount of skin back if there's muscle underneath. New skin will granulate and grow in to fill in gaps that would surprise you.
On the areas that are just uncovered, I usually use antibiotic creme (versus ointment) because it's water based. Sometimes I'll just put a thin smear of antibiotic ointment, however, if that's what I have. Or fly-preventative ointment if there are flies in the area.

KNOW THE SMELL OF CLEANLY DRESSED WOUNDS:
Because part of your job in the next few days will be trying to detect any signs of infection, it’s important that you know the smell of a freshly cleaned and dressed wounds. Wounds, because they are exposed interiors of the body, do not smell “lovely” by nature. They have a distinct smell that some might find unpleasant. However, they’re much less unpleasant than a wound that has become infected or is going necrotic. Thus it is necessary to become familiar with the “good” smell so that you can recognize the bad. Smell the wound now, remember it, and use that memory every time you examine the healing wounds. Your nose will be as impotant a tool as your eyes in keeping the healing on track.

DRESSING WITH BANDAGES:
If at all possible, try not to cover with bandages. The average bandage keeps air out and moisture in and not in a good way. If you must bandage (a dirt floor area, extreme fly issues, etc) then try to keep the bandage to a minimum and very airy. That's why I'm not a big fan of nonstick bandages. They tend to trap moisture and cause a very warm airless area. But sometimes you have to use them. If so, cover the wound with the bandage. Wrap twice with very gauzey gauze wrap. Then put one layer only of VetWrap over. If you must secure (to keep the bandage from falling, for example) you can use very thin strips of duct tape like you would tape a birthday present. Using as little as possible, but a very strong tape like duct tape, helps let the air in.
Sometimes I've even used just one layer of a very clean paper towel rather than use a non-stick. Afterwards, if you have to remove it, you can soak with warm water and pick the bits out if it sticks. Gauze tends to embed in wound seepage.
Think out of the box when it comes to covering areas that are wounded. With my geese who had multiple puncture and surface wounds on their chest, and a high fly area, I used one white sheet that I formed into a sort of front-bib and tied behind their back. T-shirts are also awesome to cover a bird's body. Buy the appropriate size, slip the neck over their neck, their legs through the arm holes, cut two holes through which you slip their wings. Gather the bottom end (cut so that you don't cover their vent) at the top of their back and duct-tape the cloth to make it stay fitted. T-shirts are very airy, cheap, washable, and absorbent.

SUTURES:
If your bird requires stitches, suture material with thread attached can be found at many feedstores or purchased online ahead of time. The size you want is for dogs and cats. Sutures aren't stitched like a pillow case, but each stitch is its own knot. The semi-circular needles of suture needles are ideal for going into and out of the skin. Note: stitching is not easy - skin is tough, usually the needle is slippery, and it's rather tough to do. Overestimate the amount of suture material you need as you'll make knots and cut off the excess bit sticking up.
It’s best to try to avoid stitching a wound if it’s from an animal bite. The mouths of carnivorous animals contain bacteria that are harmful to birds. If you must stitch, always use a drain at the bottom to allow the wound to drain, and leave a stitch open at the top (preferably with a tube into it) so that you can flush out the wound with a syringe as needed.

MAINTENANCE:
Many wounds, if properly cleaned and dressed and left airy, do not need much maintenance. Oddly, one of the best ways of telling whether or not a wound is doing well is by using your nose. Smell the wound at the time of cleaning. Wounds have a particular almost sweet but not cloyingly sweet smell. Remember the smell. Then smell the wound daily to see if you smell rot. If you do, there's not enough air to the wound and possible infection going on.
Wounds will seep a little - that's natural and the body's way of dealing with wounds. Usually the seepage will be mostly clear and smell of wound. However, if there's any opaqueness to it, or clotted texture, that's infection. Also there will be some natural inflammation as the body tries to bully off the bad bacteria and bring in healing materials to the wound. However excessive inflammation, discoloration (especially black or green), should be noted.
If a wound needs cleaning or examining, take off what bandages you can gently. If they stick to the seepage from the wound, use warm water to soak the bandage parts remaining away from the drainage.
Then examine the wound, determine what needs to be done, and redress from the iodine stage onward.

ANTIBIOTICS:
Many wounds do not require additional antibiotics other than topical (on the skin) antibiotic dressings. However in the case of animal bites that weren't caught immediately, cat bites, and wounds that have been sitting or are particularly deep, it may be a good idea to treat with antibiotics. (For cat wounds, you *must* include penicillin as one of the antibiotics and from day one with any catbite wound – even if your veterinarian prescribes Baytril.) If you make this decision, please be sure to get one that is appropriate for wounds. The packages at the feedstore are not and will only cause more problems if used for a purpose for which they’re not intended.
Penicillin G Procaine (Aqueous Pen-G) is commonly found at many feedstores in their fridge section. It's awesome to keep in your own fridge for a rainy day. It's a very thick antibiotic and requires a thicker gauge needle. I would use no thinner than a 22 gauge, preferably something more thick at a length of .75 to 1 inch. At many feedstores, you can buy 3 cc syringes that are together already with needles. These are nice to have on hand as well as that 30 cc syringe that you'll use to flush wounds.
Instructions on how to give an injection are available separately as well as how to treat with antibiotics. If you do choose to use injectable antibiotics, be prepared to go the entire recommended course. Penicillin G Procaine is a concentrated penicillin (they're not all created equally) and only is required to be given every other day. Based on the type of antibiotic you expect to use, buy that many syringes plus two.

HEALING:
Birds in healing mode need help being stabilized, nourished, and hydrated. We all know how delicate birds can be, but it's surprising how resilient they can be at times. However, wounds will often depress a bird or cause them to go into shock. A stressed or shocked bird may not be able to digest foods they're commonly given. For that reason, I recommend only giving easily dissolved feeds when a bird is in the first stages of recovery. Think crumbles, pellets, etc. You don't want to make a drastic change in their diet ever, much less when they're already stressed. If a bird is reluctant to eat, try wetting the pellets/crumbles. You can also add a boiled egg yolk (one per six cups of food) mashed into the crumbles. I like to also give probiotics (yogurt, Fastrack, Probiocs, acidophilus, or whatever I have available) during this time to combat a secondary intestinal disorder from stress and change of way of eating. Yogurt is simple. You can mix 1 tablespoon per two cups of feed.
The added protein in an egg yolk helps the bird to heal. Adding a capsule of vitamin E to that mash (one per 2 cups of mash) also helps healing. If the birds are stressy, or not able to eat normally, I'll use a vitamin/electrolyte mix in their water for the first few days. I never ever use an oral antibiotic for wound treatment. Period.

CONCLUSION:
It's unfortunately common that poultry are victims of predation and wounds. They are delicate and, with their ultra-fast metabolisms, can die readily if they decide to. Remember that an injured bird can often have internal injuries we never see. If you lose them, just remember you tried your best. However you might be surprised, with proper wound-care, how many of these birds recover to absolutely normal lives. Just be patient as healing takes a while. Usually separate the birds, but if they can be near their peers they take heart from it and will do better.

Good luck with your flock, and I hope this information has been helpful.
Nathalie Ross
(Please do not reproduce without permission of the author. The author is not a veterinarian and does not intend to dispense information that at all should replace the advice of a qualified avian vet.)

USING PENICILLIN G PROCAINE FOR POULTRY – by Nathalie Ross
Sometimes when faced with injured chickens or waterfowls we feel it is necessary to treat with antibiotics to either stop an infection, or prevent one from happening.
People often turn to their local feed store for packaged antibiotics, believing that they are appropriate for nearly all occasions. Unfortunately, these antibiotics in the water actually aren't the ones that work for infected 'wounds'. They are intended for respiratory illnesses and enteritis. The antibiotics that are appropriate for wounds are of the penicillin range, or penicillin related medicines. (Penicillin, Penicillin G Procaine, amoxicillin, etc). With the exception of amoxicillin, these drugs are most often (and most effectively) given by injection. This is particularly true of the penicillin drugs as they are very rough on the beneficial flora of the bird’s digestive tract if given orally.
Penicillin injection medicines are readily available at most feed stores; they are kept and stored in the refrigerator and should be at home as well. One of my preferred drugs for wound use, and commonly found in most stores, is Penicillin G Procaine (300,000 IU).
Penicillin is a mixture of drug particles (solids) in liquid (solution). The particles in the solution are quite large, the drug is quite thick (particularly when stored correctly in the refrigerator) so you need a larger needle to get the correct mixture of particles in solution for an injection.
Most feed stores carry 3 cc syringes pre-equipped with screw-on needles that are 25 gauge (smaller). Of course, to keep the syringe sterile, leave the needle on. The same feedstores often carry loose 18 gauge sterile needles. Buy one for each syringe. Just before you plan to pull the penicillin from the vial for the shot, remove the syringe from its packaging and unscrew the smaller needle, screw on the larger needle with its cap still on. Make sure it is screwed tightly.
Pulling the medicine: penicillin particles settle during storage. Shake the penicillin vial until the solids on the bottom are all mixed into the liquid. Uncap the syringe, and pull the plunger out 1/4cc. Push the needle into the rubber top of the vial and press the plunger to let the air into the vial. Then pull your dosage. Pull out the syringe, turn the needle up, and thump with your finger to dislodge any air bubbles from the syringe to the top of the syringe. Push the plunger gently to push out the air. Re-cap the needle; letting that syringe just come to nearly room temperature. Replace the vial into the refrigerator as soon as the injection is ‘pulled’.

Penicillin is given in the muscle (“IM” aka intramuscularly). On poultry/waterfowl, the best place to give the shot is either in the breast meat or in the thigh. I prefer in the breast meat as there is a great deal of meat, little bone, and few blood vessels.
Clean a spot far from the bone, in the middle of one half of the breast, with a tiny bit of alcohol on a bit of tissue. Uncap the syringe and put the needle into the skin – not terribly far. Less than ¼ inch for sure. Pull its plunger first and look for blood. This is to make sure the needle is not in a blood vessel. If you see blood, withdraw the needle and move the injection sight. Repeat. If you don't see blood, push the plunger in and then remove the syringe from the bird.

Pen G procaine is given daily for no more than four days. The dosage for poultry or waterfowl (under 10 pounds) is listed as less than 1/4 cc if the Penicillin G Procaine is 300,000 I.U. (which is most often is) for animals from 1-10 kg (each kg = 2 pounds, so 1-20 pounds). The dosage is actually listed as 1ml (cc) per 100 pounds of body weight, but giving 1/10th of a cc would be troublesome and it has a high safety margin.
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The cut is at the spot where leg meets body, so I can not pull skin together, like a butterfly would not actually be holding anything together because there would be a big gap behind it. Does that make sense? I just tried some steri strips I had here but they would not bring skin together... It is like her arm pit...

Three Horses thank you for info and great article!

No roosters and I am keeping her seperate and safe.

She looks like meat you buy at the store! This is the joint of her leg meeting body, I can see the drumstick meat and part of her breast meat.

I do not know how to put skin back.

It does make sense - if you can't put it back together, just "clean it like you mean it", keep it covered in neosporin, and keep her up for three days then - it'll granulate back in. Likely bandages wouldn't work as that area is quite mobile. I also prefer to keep those things open and things out of them rather than bandaging because bandages keep air out, and these things need air to heal - just cleanness.

By the way, do be sure to smell the wound today while it's fresh and not lovely smelling, but the smell of a GOOD wound - not a rotten one. Remember that smell, note it. That way you can tell if it's going bad.

Quote:
Sorry I might be a little thick at the moment, Do you mean I should stitch or should not stitch it back together? I do have some human dissolvable suture material.

It seems like there is an air sac in this area as well. Is that of any concern?

Wound smells very clean and healthy! Well noted and well cleaned!

and is it OK to have the neosporin inside her? I could squeeze a lot into her arm pit and under her skin. Should I put that much in?

The skin on the left is part of her leg so the two edges of the wound do not meet, there would be an air pocket if I drew them together.