How to suture

First of all, No the pigs feet were not attached to the live pigs. They were cleaned and in preservative and they looked like Franenstien by the time we got finished with them.

Oliver brings in a good point,staples. They come ready to use and are easier to use than sutures. But you still have the same concern about cleaning the wound and it's still going to hurt. They don't hurt near as much coming out.

Once again I must stress that there are too many affective alternatives to get stuck on suturing. As long as the wound is cleaned and the edges are well approximated and held together it will heal just fine. While growing up I spent most of my time in the woods and we would get some bad cuts while learning to do things right. We knew if we showed our parents they would take us to the Dr. and we didn't want to go. We would tape our cuts together with black tape or wrap them tight with rags and never had any problem.

This is a good thread,a lot of emotion.

Thatmguy, I don't know of any training to help you beside that in the medical field. If you could hook up with a trauma nurse or MD. they may be willing to share the knowledge and skill required. Just remember you have plenty alternatives if needed. So hay lets sew up the attitudes and stay on topic....:D :p :D:D
 
My wife is a veterinarian, and we've had this conversation before regarding my solo trips. She seems to think suturing is a little skill-intensive and that the various glues hold lots of promise, especially considering that you are generally tired and/or beat up if you are to the point of reassembling yourself. Cleaning and dependably sealing the wound are the critical aspects; the method doesn't matter. She often uses tape alone on active animals with large cuts/tears. Sutures are too weak and often don't seal as cleanly. Prophylactic antibiotics go a long way, too.

Her recommendation to me? Clean it, glue it, tape it, get your butt home!

Scott

PS: Don't use betadine in an open wound, as it will tend to make you shocky.
 
Most wounds (especially those only needing a couple of stitches) will heal w/o sutures. It will just take longer & leave a worse scar. A could compromise between a crappy closure and a gaping wound would be to use steri-strips, or medical tape at the worst. Space them about 1/8"-1/4" apart, apply perpendicular to the wound. Do not apply lots of tension - this may lead to blisters. A little tincture of benzoin will help the tape strips stick better, and they can last for a couple of weeks if kept clean and dry. If you do not adequately clean the wound, you risk abscess formation & systemic infection. The new medical glues work well when used as directed - read the instructions. The goal is to not get any glue in the wound, but to apply several thin coats over the wound while the wound edges are held in good approximation. Surgical glues (dermabond) is not indicated if there is a lot of tension on the wound. It is designed for small, clean, low tension wounds (we now use it in the OR to seal surgically closed wounds - seems to work ok, but steri-strips work well in this role as well).

Staples are easy to use, but they are easy to misuse as well - you still need to insure proper eversion of the skin edges ro you risk poor approximation & slow wound healing.

The object in closing a clean wound is to eliminate any potential or "Dead" space created by the wound, approximate tissues in their normal anatomic position and to close the wound w/ adequate support while not causing ischemia to the wound edges - approximate, don't strangulate.

If (and this is a big IF) you decide you must carry suture supplies, you are better off using straight needles - curved needles are meant to be used w/ a needle holder, and while a pair of pliers might get the job done, getting/keeping them sterile would be a pain. Many common suture materials are available on a straight cutting needle. With a pair of sterile gloves, a 3-0 nylon on a straight needle & a pair of forceps, you could _probably_ close most superficial wounds.

Wounds to the arms & back may cause problems - hard to manipulate tissue & even harder to tie a knot w/ only one hand.

I also learned to suture on pig's feet. They tend to be a little thicker/tougher than human skin (except the back - skin on the back can very tough), but they are perfectly adequate for practice. After practicing on the pig's feet, I was not ready to just dive in a start closing wounds. It does take practice & experience to know how to close a wound, how many sutures/type of sutures are needed, etc...

In my experience, diluted Betadine used as irrigation has no significant detrimental effect to a properly cleaned & irrigated wound ( I usually use the betadine 1st, then repeat several times w/ normal saline). I would not use it undiluted, as it can be damaging to tissues.

Be careful.

Find a nice Doc to take you through the steps.

See if any of the local hospitals have any community programs (my hospital runs a mini-medical school, as well as many community education programs).
 
I'm a special case - I'm allergic to Betadine. I didn't know this until I put myself in shock when I applied dilute, ~1:10, Betadine to a cut thumb. I also have a friend who nearly died when EMTs tried to clean her wounds with Betadine after a car wreck. During my 10 years as an EMT I was not allowed to use it for this reason.

I don't know what the statistics are, but I doubt the allergy is extremely rare. I carry 2% Chlorhexidine Gluconate, which is my wife's favorite wound flushing concentrate, instead. You can get it at farm supply stores by the gallon, where you can also find lots of suturing suplies.

I guess I'm just not a good candidate for "standard" medicine - I'm also allergic to penicillin :) .

Scott
 
I think alot of people forgot the fact that we might not suture ourselves but someone else.
 
As a physcian who sutures almost daily (and as a former Army Medic) I can say that I do NOT carry sutures in the woods. If part of a large group where I could carry all the other things needed i.e. gloves, lidocaine, needles, syringes, sterile instruments; then I wouls and have have sutured in the field.
All wounds will heal without suturing. Most wounds in the wilderness are best treated with irrigation with clean water and either taping or just a clean dressing.
You can never go wrong carring duct tape. As for super glue it works well on the face and poorly on hands (except for fingertips). However it closes a wound and if there is dirt or a lot of contamination you are setting yourself up for an infection.
 
Cool guys. I think my best bet is to stick with a good irrigation setup (sterile water packets and syringe), maybe an anaeseptic rinse, butterflys/coverstrips, and duct tape.

I'll leave the sewing to the pros. (unless of course the SHTF, then it won't matter..)

That helps a lot.

Thanks.
 
You must log in or register to reply here.
Back
Top