Wound Care Advice for Silkie Hen (Caution: Pictures)

Discussion in 'Emergencies / Diseases / Injuries and Cures' started by blusuede, Mar 8, 2016.

  1. blusuede

    blusuede Out Of The Brooder

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    May 2, 2015
    Hi everyone,

    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:

    [​IMG]

    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):

    [​IMG]

    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):

    [​IMG]

    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!

    Thank you!
     
  2. Eggcessive

    Eggcessive True BYC Addict

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    Wow, you have done a great job with her. Fly strike infection is tough to treat, and you have done an excellent job explaining all your steps. Getting all of the maggots out with tweezers and soaking will be the biggest issue. I might try a bath in warm epsom salts or soapy water, and some gentle scrubbing of the surrounding tissue, and a warm rinse afterward. Keep her very warm and get her dry, of course. Then smother the wound in some Bacitracin ointment 1-2 times a day to hopefully start the healing. Feathers will take a month or so to start coming back in. I would make her a little shirt to keep the others from pecking out the new feathers. Polarfleece is easily fashioned into a hen apron with small slits for the wings.
    Do you know how she got the wound? Rooster or a predator? Re-integrating her back into the flock should ge done very gradually with visits out free ranging, and maybe being in a cage inside the coop with food and water for a bit.
     
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  3. blusuede

    blusuede Out Of The Brooder

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    May 2, 2015
    Thank you Eggcesive :)

    I believe the wound came from our roosters. We have 3 roosters and 5 hens, which of course is too many as 2 were supposed to be hens. (Several of our hens disappeared too so the flock used to be larger.) We have been trying to rehome 2 of them with little luck. I have a couple promising leads right now though.

    Right now she is living in our bathtub. Do you think it's okay for her to stay there until she heals? Or should I place her back outside? My preference would be to keep her indoors and we have the capacity to do that, thank goodness.

    I had thought about a bath too so I'm glad you said that. It's almost impossible for me to catch those stupid little maggots with tweezers--but admittedly, I haven't tried. I have done a lot of lavaging to flush them out but I will try the tweezers as well next time.

    Any advice on removing the rest of that surrounding tissue? It is so much tissue...and she is tiny. In the hospital (taking care of adults), I did wound care often, but not to this magnitude. I would also have specialized dressings that I do not have for Nora--and extra support! Lol Which I have here with you guys, so thank you!
     
  4. Eggcessive

    Eggcessive True BYC Addict

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    I'm an RN also, and when I would help out on the burn unit with kids, we just used a whirlpool and hibiclens (chlorhexidene,) but 20 years ago it was just Dial soap. I would use a little thin wash cloth, and gently scrub the necrotic skin. That's what I tell people with necrotic vents from prolapsed vents to do. Then use some plain antibiotic ointment. With a silkie's dark skin, it would be difficult to distinguish the necrotic skin from the healthy skin.
    Some recommend a permethrin product to get the maggots, something like Swat fly repellent for horses. I would file the roosters' sharp spurs, also, so this doesn't happen again.
    Thanks for posting this, since it helps a lot of people when they are doing searches at the top of this page on different subjects. Here are a few threads about fly strike, since many people treat it differently:
    https://www.backyardchickens.com/t/...has-huge-hole-below-vent-fly-strike-confirmed
    https://www.backyardchickens.com/t/...autionary-tale-with-graphic-photo-progression
    http://www.the-chicken-chick.com/2014/07/flystrike-in-backyard-chickens-causes.html
    https://www.backyardchickens.com/t/822173/fly-strike-picture-of-wound-progression-of-healing

     
    Last edited: Mar 8, 2016
    1 person likes this.
  5. blusuede

    blusuede Out Of The Brooder

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    May 2, 2015
    Love these links, thanks so much! You made a good point about her skin being dark so I went back and checked, and while the tissue is somewhat thick and leathery as compared to the softer, thinner skin distal to the wound, I am going to take your advice and try the bath and bacitracin to see if any of that can be softened up. The edges are clean and my 7yo daughter continues to tell me that "Nora is looking sooo much better mom!" Looks like she is on the mend! Lol Thanks again!
     
  6. deacons

    deacons Chillin' With My Peeps

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    I have no good advice, just wanted to offer you and Nora good thoughts for speedy recovery. While I have not personally had to treat a body wound that large, I have seen some pretty incredible evidence of chickens healing on this forum. With your excellent care, I'd say she's got a great shot at recovery!
     
  7. blusuede

    blusuede Out Of The Brooder

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    Thank you deacons!

    Eggcessive: Would you recommend the bacitracin beneath the Vetericyn or in place of it?
     
  8. Eggcessive

    Eggcessive True BYC Addict

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    I think both are good, but the ointment will help to smother any remaining maggots as well as help in keeping the skin soft. Plain Neosporin is good too if you have that. I just looked at the first picture again, and some of the egdes of her skin look a bit greenish, which is probably bruising. Sometimes betadine will do that to chicken skin as well.
     
  9. blusuede

    blusuede Out Of The Brooder

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    Following Eggcessive's advice, I gave Nora a lukewarm salt bath. I had to use sea salt because that's all I had (and it was even expensive French sea salt for cooking - you're welcome Nora).

    Here is the picture of the wound prior to getting in the salt bath. The last wound care was done around 0900 this morning:

    [​IMG]

    I soaked her in a lukewarm salt bath for about 10 minutes. I added a cup of warm water about 3 times during the bath to keep her warm. That's a tip I would recommend for anyone else reading this that has never done this before (such as myself), especially because Nora is so small and she will lose a lot heat quickly. Don't let them get cold! I'm amazed at how well she did in the bath. I used a carwash bucket in the shower and am AMAZED at the maggots that floated to the top! Especially because I only saw 2 before the bath! This was a great recommendation from Eggcessive that I highly recommend!!

    Here are a few photos after her bath:

    [​IMG]

    Heat lamp is casting orange glow:

    [​IMG]
    [​IMG]

    I did cover the wound with a thin layer of bacitracin and globbed it into a small little hole at the bottom of the wound before spraying the Vetericyn over it tonight. I'm amazed at how good this is looking from where we started. I thought it was a lost cause but I give full credit to everything I have learned here on BYC! And the bath did wonders for the skin surrounding the wound. I think it is fully viable whereas before I thought it was necrotic or at least heading that direction. It just needed a little TLC!

    Meet Nora! This also gives you an idea of where her wound is:

    [​IMG]

    [​IMG]

    This photo is useless for wound reference but she looks sophisticated ;)

    [​IMG]

    I cleaned out her box and put all new pine shavings in. I dried her off as well as I could and plugged in the heat lamp to keep her warm.

    And the wound care continues! She has 3 more days of daily penicillin injections, and we will continue to flush her wound twice daily with warm sterile water, betadine solution, and finish off with bacitracin and Vetericyn gel.

    Thank you all!
     
  10. ChickenFox

    ChickenFox Chillin' With My Peeps

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    Looks like you have everything well in hand, and Nora seems to be recovering nicely. Still sending some extra positive thoughts your way though!
     

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