Field sutures......VIDEO. A little graphic. - Page 1

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Posted: 10/30/2009 2:20:20 PM EST

I have to admit, I was cringing a bit.

Posted: 10/30/2009 2:22:52 PM EST

[#1]

That made you cringe?

Posted: 10/30/2009 2:25:21 PM EST

[#2]

Cut wasn't that bad.

Drama queen.

Posted: 10/30/2009 2:25:36 PM EST

[#3]

Quoted:

That made you cringe?

Thank you.

Posted: 10/30/2009 2:29:22 PM EST

[#4]

Good Skill doing it pretty much one handed

Posted: 10/30/2009 2:29:44 PM EST

[#5]

Dude made every possible effort he could to contaminate that once sterile suture.

Posted: 10/30/2009 2:32:35 PM EST

[#6]

Quoted:
Cut wasn't that bad.

Drama queen.

This and nice TATS!!!!

Posted: 10/30/2009 2:35:59 PM EST

[#7]

Wow, that needle is HUGE!! Also, if you're going to do this at home - #1 most important thing is get the cut absolutely clean. Very very clean, irrigate the shit out of it. Also, the tools need to be sterile. If he's got crap on his multitool, he just transferred it to the needle and then passed it through his skin.

Posted: 10/30/2009 2:36:53 PM EST

[#8]

Quoted:
That made you cringe?

Yes, I was referring to the needle into skin, not blood. I'm not a fan of pain, sorry.

Posted: 10/30/2009 2:38:02 PM EST

[#9]

Quoted:
Dude made every possible effort he could to contaminate that once sterile suture.

I noticed that too.....

. Looked like a shop rag he was using

.

Posted: 10/30/2009 2:39:18 PM EST

[#10]

Quoted:
Dude made every possible effort he could to contaminate that once sterile suture.

lol that's what I was thinking. He would have been better off using crazy glue and leaving one end open. The guy needs to spend some time suturing inanimate objects before he tries on himself again.

ETA: and I call bs on a brand new needle being dull. It was more than sharp enough to rip the skin a few times.

Posted: 10/30/2009 2:39:45 PM EST

[#11]

Quoted:

Quoted:

Dude made every possible effort he could to contaminate that once sterile suture.

I noticed that too.....

. Looked like a shop rag he was using

.

He did himself no favors trapping all that crud inside his body. That video was pretty dumb and I definitely wouldn't have uploaded it to show the world how dumb I was.

Posted: 10/30/2009 2:40:24 PM EST

[#12]

tagged for sound

Posted: 10/30/2009 2:40:36 PM EST

[#13]

Staples, butterflies and irrigation for the win.

Pretty good example of why sutures are pretty much not a solo, field expedient method.

Posted: 10/30/2009 2:41:12 PM EST

[#14]

Frankly the further I get in nursing school the less I consider sutures to be something someone should be considering doing themselves in anything but the most dire circumstances.

Posted: 10/30/2009 2:41:37 PM EST

[#15]

Cool video.

The cuts wasn't that bad and didn't technically need stitched but it's a good lesson. I've had to do this myself once and it was not fun.
Learned the skill from a Corpsman but never thought I would ever have to do it to myself.

Posted: 10/30/2009 2:44:06 PM EST

[#16]

It would be a bitch to suture your own hand. It would have been okay to leave that open or taped closed to heal in a pinch. I would have tried to use the multi tool as a needle driver though. SS

Posted: 10/30/2009 2:45:44 PM EST

[#17]

Quoted:

Frankly the further I get in nursing school the less I consider sutures to be something someone should be considering doing themselves in anything but the most dire circumstances.

I completely agree. No nursing school though.

Posted: 10/30/2009 2:47:56 PM EST

[#18]

warrior stamps all over that dude - no wonder he was tough enough to use a massive, dull needle and twine to stitch himself up.

I cut myself almost as bad last weekend and just rubbed an alcohol swab on it, then a cheap band aid. Perhaps if I had some warrior stamps I could've done more...

Posted: 10/30/2009 2:50:14 PM EST

[#19]

I just got to the part where he drops the multi-tool on the floor then continues to use it as a needle driver

I've never left a comment on a youtube video, but I'm tempted to just because so many people seem to think that what he demonstrates is close to what you'd actually want to do.

Posted: 10/30/2009 2:50:33 PM EST

[#20]

Was this a how to or a how not to?

Posted: 10/30/2009 2:52:46 PM EST

[#21]

Which brings me to a question I had last night in my sleep.

Sew up a wound and deal with the needle pain or deal with the pain of super glue in a wound?

Or am I totally off base with the super glue? I guess that super glue can't be good to put into a wound that needs stictches.
Another question, what are butterfly stitches, what are they good for and where can I get them.

Yes, I am ignorant about first aid.

Posted: 10/30/2009 2:53:00 PM EST

[#22]

Quoted:
I have to admit, I was cringing a bit.

This video, gents is EXACTLY why I carry STAPLES. OWOWOWOWOOWOWOOW!

Posted: 10/30/2009 2:55:22 PM EST

[#23]

Quoted:
Which brings me to a question I had last night in my sleep.

Sew up a wound and deal with the needle pain or deal with the pain of super glue in a wound?

Or am I totally off base with the super glue? I guess that super glue can't be good to put into a wound that needs stictches.

Another question, what are butterfly stitches, what are they good for and where can I get them.

Yes, I am ignorant about first aid.

you don't put super glue in the wound. you push the edges together and put the glue on top. You don't want to cover the whole thing though, because you want it to be able to drain. If you suture like that guy, you're probably better off with super glue for the infection risk alone.

HERE is a butterfly bandage. It's used to hold the edges of wounds like this together.

That said, suturing is relatively easy. This guy makes it look a lot harder than it is and his "pass the needle through the sutures a bunch of times" method of tying is 100% wrong. If anything, it increases the risk of infection by giving bacteria more surface area to adhere to. I'm not a physician, but his thing about 5-0 chromic gut being too thick for the skin on your knuckles doesn't make sense to me. At my school, we generally use 3-0 chromic (which is bigger than 5-0) in the mouth, and 4-0 silk (which is much easier to tie than chromic) in areas that are more likely to scar (lips, etc.) If anything, I'd htink 5-0 chromic would be thin for such thick skin.

Posted: 10/30/2009 2:55:30 PM EST

[#24]

Quoted:

Which brings me to a question I had last night in my sleep.

Sew up a wound and deal with the needle pain or deal with the pain of super glue in a wound?

Or am I totally off base with the super glue? I guess that super glue can't be good to put into a wound that needs stictches.
Another question, what are butterfly stitches, what are they good for and where can I get them.

Yes, I am ignorant about first aid.

You don't pour superglue into the wound. You pinch the wound close and dress the surface with the glue, carefully leaving one or two corners of the wound (depending on size) glue free for drainage. Think about it. If you coat the inside of the wound with acetate, how is it going to knit back together?

Posted: 10/30/2009 3:45:48 PM EST

[#25]

ouch...saves an ER bill though...

Posted: 10/30/2009 4:36:47 PM EST

[#26]

Quoted:

ouch...saves an ER bill though...

not if it gets infected. . .

Posted: 10/30/2009 4:43:48 PM EST

[#27]

I have had worse cuts that I just duct taped together.

Posted: 10/30/2009 4:57:32 PM EST

[#28]

Idiot doesn't understand the basics behind what he's trying to do.

Sepsis isn't your friend.

Posted: 10/30/2009 4:57:57 PM EST

[#29]

I have packages of prolene blue monofilament. They seem to be a very fine hook and line for stitchtes.
Where can I learn how to use these packages.

I know it seems stupid for someone like me to have them but I would like to know how to "basically" use them.

I understand that infection can occure and I understand that. But when worse comes to worse. I would like to be able to use these sealed packs.

Rambo stitched himself up.

I've ran out of local, so what next.

no hospital exist, but I have iodine?
E.T.A. I just whatched the viedo. I have the same 5-0 and 6-0 suture kits.

WTH?

Posted: 10/30/2009 5:00:24 PM EST

[#30]

'

IMO, "field" suturing is fucking stupid. In austere conditions you are better off letting the wound heal from the inside out, especially one thats to the bone and several hours old.

Posted: 10/30/2009 5:03:55 PM EST

[#31]

Quoted:

ouch...saves an ER bill though...

not if when it gets infected. . .

fixed

Posted: 10/30/2009 5:09:46 PM EST

[#32]

Holy "Hold my beer, watch this"

Shop rag that looks like he just used it to wipe down his oil pan
Dirty multi-tool as a needle driver
5-0 Chromic: pretty lightweight for high mobility/use area like hand (and dissolves too fast anyway). Should be using 4-0 Nylon or Prolene
Needle was plenty sharp (just came out of the pack) –– wasn't penetrating skin likely beacuse it was a taper needle not a cutter
Totally bizarre sewing technique
No disinfectant and not nearly enough irrigation
Huge needle and suture contamination - (you really don't want an infected joint in the hand)

Gonna make some hand surgeon some big bucks someday when he manages to infect himself and needs reconstruction

Posted: 10/30/2009 5:25:04 PM EST

[#33]

what he did was obviously lacking and I know this as a civi. It looked dirty and not life threatening.

What he did was also lacking, even if there was no other place to stitch you up.

If there were no hospitals, what he was stitching up seemed more of a liabilaty than a good idea. Why not loose the use of your hand for 20 days and die than die from an infection?
If teotwawki happened, would there ever be a reason to have a stitch kit?

Posted: 10/30/2009 5:27:48 PM EST

[#34]

Quoted:

what he did was obviously lacking and I know this as a civi.

What he did was also lacking, even if there was no other place to stitch you up.

If there were no hospitals, what he was stitching up seemed more of a liabilaty than a good idea.
If teotwawki happened, would there ever be a reason to have a stitch kit?

For a big open wound, yeah.

But a little cut like that, the only reason to get sutures is vanity - not wanting a bigger scar. There's kind of a logical disconnect between the tats and not wanting a scar though...I guess putting a video on youtube of him suturing himself was the most manly course of action.

Posted: 10/30/2009 5:31:42 PM EST

[#35]

Quoted:

Quoted:

what he did was obviously lacking and I know this as a civi.

What he did was also lacking, even if there was no other place to stitch you up.

If there were no hospitals, what he was stitching up seemed more of a liabilaty than a good idea.
If teotwawki happened, would there ever be a reason to have a stitch kit?

For a big open wound, yeah.

But a little cut like that, the only reason to get sutures is vanity - not wanting a bigger scar. There's kind of a logical disconnect between the tats and not wanting a scar though...I guess putting a video on youtube of him suturing himself was the most manly course of action.

I've edited my post and I understand what you are talking about.

I agree, vanity is not a reason to stitch.

What happens in the wild when you are alone and you need your hands. If a wound keeps opening up, then what do you do?

I have plenty of gorilla tape but what if that doesn't work.

How do I learn how to sew up me or someone?

Posted: 10/30/2009 5:32:05 PM EST

[#36]

Quoted:
I have packages of prolene blue monofilament. They seem to be a very fine hook and line for stitchtes.

Where can I learn how to use these packages.

I know it seems stupid for someone like me to have them but I would like to know how to "basically" use them.

I understand that infection can occure and I understand that. But when worse comes to worse. I would like to be able to use these sealed packs.

Rambo stitched himself up.

I've ran out of local, so what next.

no hospital exist, but I have iodine?

E.T.A. I just whatched the viedo. I have the same 5-0 and 6-0 suture kits.

WTH?

Facts, the vast majority of suturing is performed for cosmetic reasons. Wounds which truly require suturing almost always require definitive care above and beyond sutures. Suturing is a skill that's of limited value in a field setting.

Medical care is a skill set that needs to be approached from the ground up. Start with a solid first aid or first responder course. Take a basic A&P course. (The big problem with any medical training above first aid for someone who isn't functioning as a healthcare provider is retention. A grounding in anatomy and physiology makes the 'why' behind things clearer, so it helps with retention) Then, if you're serious about wanting to be able to perform advanced procedures, look into something like Resqdoc's remote medicine class.

Posted: 10/30/2009 5:40:45 PM EST

[#37]

Quoted:

Quoted:

I have packages of prolene blue monofilament. They seem to be a very fine hook and line for stitchtes.
Where can I learn how to use these packages.

I know it seems stupid for someone like me to have them but I would like to know how to "basically" use them.

I understand that infection can occure and I understand that. But when worse comes to worse. I would like to be able to use these sealed packs.

Rambo stitched himself up.

I've ran out of local, so what next.

no hospital exist, but I have iodine?
E.T.A. I just whatched the viedo. I have the same 5-0 and 6-0 suture kits.

WTH?

Facts, the vast majority of suturing is performed for cosmetic reasons. Wounds which truly require suturing almost always require definitive care above and beyond sutures. Suturing is a skill that's of limited value in a field setting.

Medical care is a skill set that needs to be approached from the ground up. Start with a solid first aid or first responder course. Take a basic A&P course. (The big problem with any medical training above first aid for someone who isn't functioning as a healthcare provider is retention. A grounding in anatomy and physiology makes the 'why' behind things clearer, so it helps with retention) Then, if you're serious about wanting to be able to perform advanced procedures, look into something like Resqdoc's remote medicine class.

I was picking up what you were putting down for a while.

What your are saying though is that, when I have to deal with total melt down of every social service, my suiture kits are of no use period.

Then I have to ask, If I get a puncture wound, I die? Is there no way to clean it and close it?

Posted: 10/30/2009 5:40:53 PM EST

[#38]

Suturing little wounds like that is mainly a product of modern aseptic techniques. Back in the day, many more wounds were left to heal by secondary intention –– meaning they were left open to heal from the inside out. In a situation where you couldn't get the wound really clean, it would be better to let it heal that way. Closing bacteria inside the wound just gives it a nice home to live in.

There are some advantages to primary closure though –– even for smaller wounds. The biggest issue with secondary intention is that there is a lot more scar formation and scars contract. In a sensitive area like a finger joint, scar contracture could mean a loss of mobility. Obviously in a survival situation it is better to keep the hand (and not risk serious systemic infection) than have some mobility loss. The other area where closing small wounds makes sense is in cosmetically sensitive areas like the face, ears, nose, and lips.

Posted: 10/30/2009 5:44:13 PM EST

[#39]

Quoted:

Quoted:
what he did was obviously lacking and I know this as a civi.

What he did was also lacking, even if there was no other place to stitch you up.

If there were no hospitals, what he was stitching up seemed more of a liabilaty than a good idea.

If teotwawki happened, would there ever be a reason to have a stitch kit?

For a big open wound, yeah.

But a little cut like that, the only reason to get sutures is vanity - not wanting a bigger scar. There's kind of a logical disconnect between the tats and not wanting a scar though...I guess putting a video on youtube of him suturing himself was the most manly course of action.

I've edited my post and I understand what you are talking about.

I agree, vanity is not a reason to stitch.

What happens in the wild when you are alone and you need your hands. If a wound keeps opening up, then what do you do?

I have plenty of gorilla tape but what if that doesn't work.

How do I learn how to sew up me or someone?

in all seriousness, you'd be better off using crazy glue than doing what he did. Crazy glue isn't going to grow bacteria, but that guy did a lot of things to contaminate the wound/instruments and promote infection.

It really amazes me that he didn't have the slightest clue of how to at least tie the knots. It's really not difficult and it took me about 10 seconds to find good videos on suture tying on youtube. Every piece of suture in a wound is a place where bacteria can sit. That guy's "technique" of randomly passing the needle through through the sutures until it seemed good enough ads a ton of excess suture material and probably screws up the tension on the suture. He's gonna end up with a nasty scar.

eta:

Then I have to ask, If I get a puncture wound, I die? Is there no way to clean it and close it?

if you get a puncture wound (I assume you're talking about something deep), you're better off leaving it open than suturing it without proper aseptic technique. As mentioned above, if you close a wound without properly debriding it, all you're doing is sealing the bacteria into your body.

Posted: 10/30/2009 5:44:48 PM EST

[#40]

Quoted:

Quoted:

I have packages of prolene blue monofilament. They seem to be a very fine hook and line for stitchtes.
Where can I learn how to use these packages.

I know it seems stupid for someone like me to have them but I would like to know how to "basically" use them.

I understand that infection can occure and I understand that. But when worse comes to worse. I would like to be able to use these sealed packs.

Rambo stitched himself up.

I've ran out of local, so what next.

no hospital exist, but I have iodine?
E.T.A. I just whatched the viedo. I have the same 5-0 and 6-0 suture kits.

WTH?

Facts, the vast majority of suturing is performed for cosmetic reasons. Wounds which truly require suturing almost always require definitive care above and beyond sutures. Suturing is a skill that's of limited value in a field setting.

Medical care is a skill set that needs to be approached from the ground up. Start with a solid first aid or first responder course. Take a basic A&P course. (The big problem with any medical training above first aid for someone who isn't functioning as a healthcare provider is retention. A grounding in anatomy and physiology makes the 'why' behind things clearer, so it helps with retention) Then, if you're serious about wanting to be able to perform advanced procedures, look into something like Resqdoc's remote medicine class.

I was picking up what you were putting down for a while.

What your are saying though is that, when I have to deal with total melt down of every social service, my suiture kits are of no use period.

Then I have to ask, If I get a puncture wound, I die? Is there no way to clean it and close it?

Very few cases will require actually closing it. This is where dressings and dressing changes come in to play. Keeping an eye on drainage, all that.

Posted: 10/30/2009 5:47:43 PM EST

[#41]

"There are some advantages to primary closure though"
obviously this is what I'm interested in

How do I learn about that?

Posted: 10/30/2009 5:49:04 PM EST

[#42]

Quoted:

Quoted:
I have packages of prolene blue monofilament. They seem to be a very fine hook and line for stitchtes.

Where can I learn how to use these packages.

I know it seems stupid for someone like me to have them but I would like to know how to "basically" use them.

I understand that infection can occure and I understand that. But when worse comes to worse. I would like to be able to use these sealed packs.

Rambo stitched himself up.

I've ran out of local, so what next.

no hospital exist, but I have iodine?

E.T.A. I just whatched the viedo. I have the same 5-0 and 6-0 suture kits.

WTH?

Facts, the vast majority of suturing is performed for cosmetic reasons. Wounds which truly require suturing almost always require definitive care above and beyond sutures. Suturing is a skill that's of limited value in a field setting.

Medical care is a skill set that needs to be approached from the ground up. Start with a solid first aid or first responder course. Take a basic A&P course. (The big problem with any medical training above first aid for someone who isn't functioning as a healthcare provider is retention. A grounding in anatomy and physiology makes the 'why' behind things clearer, so it helps with retention) Then, if you're serious about wanting to be able to perform advanced procedures, look into something like Resqdoc's remote medicine class.

I was picking up what you were putting down for a while.

What your are saying though is that, when I have to deal with total melt down of every social service, my suiture kits are of no use period.

Then I have to ask, If I get a puncture wound, I die? Is there no way to clean it and close it?

Your example makes the perfect point;

If you get a puncture wound, you follow the training out of your wilderness first aid course, pull the wound irrigation syringe and cath out of your kit and irrigate the hell out of it with saline, sterile water or potable water. If it's a huge wound, you pack it with sterile dressing material. You don't suture closed a significant puncture wound because suturing closed a puncture wound is a great way to develop sepsis and die. No physician would do such a thing for that very reason. Let me repeat that - suturing deep wounds closed in austere environments is a great way to kill your patients. Control the bleeding, clean the wound, clean it some more, then clean it again, then close the small shit with butterflys or pack the big shit with sterile packing material and let it granulate in and heal.

The vast, vast majority of the time, suturing is done to mitigate scarring or for convenience, not to preserve life or limb. When it is done as a life saving measure, it's stuff like tying off blood vessels. If you need to ligate a vessel, you need real surgical capability or that limb will die, your patient will develop sepsis and they'll die. It's very difficult to imaging any sort of plausable scenerio where a couple of packets of suture material will be the difference between life / significant morbidity or a better outcome.

Besides, chicks dig scars.

Posted: 10/30/2009 5:54:25 PM EST

[#43]

Good way to get a bone infection, which are always nice.

That being said, he did a decent job closing with only one hand, I will give him credit for that.

Posted: 10/30/2009 5:59:45 PM EST

[#44]

Quoted:
Frankly the further I get in nursing school the less I consider sutures to be something someone should be considering doing themselves in anything but the most dire circumstances.

If you have good sterile technique and know when to use them sutures aren't bad.

But there are other easier things to do too. Butterfly sutures, staples, super glue.

Another neat little thing is that if he would have irrigated that wound, covered it with a sterile dressing, and splinted the finger to prevent it from moving, it would have healed on it's own.

edited to add.

I got stupid with a knife and cut a .25 inch wide by .75 inch long flap from the side of my left pointer finger. It was fairly deep. I irrigated it would hydrogen peroxide/betadine mix, butterfly sutured it, put a splint on it to keep from bending the finger and it was fine.

If it would have gotten warm, stunk, or oozed pus I would have went to the doc. I cut the finger at the vol fire department and didn't want to fill out the accident paperwork.

Posted: 10/30/2009 6:02:10 PM EST

[#45]

Quoted:

Quoted:

I have packages of prolene blue monofilament. They seem to be a very fine hook and line for stitchtes.
Where can I learn how to use these packages.

I know it seems stupid for someone like me to have them but I would like to know how to "basically" use them.

I understand that infection can occure and I understand that. But when worse comes to worse. I would like to be able to use these sealed packs.

Rambo stitched himself up.

I've ran out of local, so what next.

no hospital exist, but I have iodine?
E.T.A. I just whatched the viedo. I have the same 5-0 and 6-0 suture kits.

WTH?

Facts, the vast majority of suturing is performed for cosmetic reasons. Wounds which truly require suturing almost always require definitive care above and beyond sutures. Suturing is a skill that's of limited value in a field setting.

Medical care is a skill set that needs to be approached from the ground up. Start with a solid first aid or first responder course. Take a basic A&P course. (The big problem with any medical training above first aid for someone who isn't functioning as a healthcare provider is retention. A grounding in anatomy and physiology makes the 'why' behind things clearer, so it helps with retention) Then, if you're serious about wanting to be able to perform advanced procedures, look into something like Resqdoc's remote medicine class.

I was picking up what you were putting down for a while.

What your are saying though is that, when I have to deal with total melt down of every social service, my suiture kits are of no use period.

Then I have to ask, If I get a puncture wound, I die? Is there no way to clean it and close it?

Your example makes the perfect point;

If you get a puncture wound, you follow the training out of your wilderness first aid course, pull the wound irrigation syringe and cath out of your kit and irrigate the hell out of it with saline, sterile water or potable water. If it's a huge wound, you pack it with sterile dressing material. You don't suture closed a significant puncture wound because suturing closed a puncture wound is a great way to develop sepsis and die. Let me repeat that - suturing deep wounds closed in austere environments is a great way to kill your patients. Control the bleeding, clean the wound, clean it some more, then clean it again, then close the small shit with butterflys or pack the big shit with sterile packing material and let it granulate in and heal.

The vast, vast majority of the time, suturing is done to mitigate scarring or for convenience, not to preserve life or limb. When it is done as a life saving measure, it's stuff like tying off blood vessels. If you need to ligate a vessel, you need real surgical capability or that limb will die, your patient will develop sepsis and they'll die. It's very difficult to imaging any sort of plausable scenerio where a couple of packets of suture material will be the difference between life / significant morbidity or a better outcome.

Besides, chicks dig scars.

Turns out, I want to learn alot. But I know nill.
How many inches below grade does a footing have to be in Cincinnati? The bottom of the footing not the top.

Ha, gatcha.

trick question.

Posted: 10/30/2009 6:14:35 PM EST

[#46]

Quoted:

Quoted:
I have packages of prolene blue monofilament. They seem to be a very fine hook and line for stitchtes.

Where can I learn how to use these packages.

I know it seems stupid for someone like me to have them but I would like to know how to "basically" use them.

I understand that infection can occure and I understand that. But when worse comes to worse. I would like to be able to use these sealed packs.

Rambo stitched himself up.

I've ran out of local, so what next.

no hospital exist, but I have iodine?

E.T.A. I just whatched the viedo. I have the same 5-0 and 6-0 suture kits.

WTH?

Facts, the vast majority of suturing is performed for cosmetic reasons. Wounds which truly require suturing almost always require definitive care above and beyond sutures. Suturing is a skill that's of limited value in a field setting.

Medical care is a skill set that needs to be approached from the ground up. Start with a solid first aid or first responder course. Take a basic A&P course. (The big problem with any medical training above first aid for someone who isn't functioning as a healthcare provider is retention. A grounding in anatomy and physiology makes the 'why' behind things clearer, so it helps with retention) Then, if you're serious about wanting to be able to perform advanced procedures, look into something like Resqdoc's remote medicine class.

I was picking up what you were putting down for a while.

What your are saying though is that, when I have to deal with total melt down of every social service, my suiture kits are of no use period.

Then I have to ask, If I get a puncture wound, I die? Is there no way to clean it and close it?

Your example makes the perfect point;

If you get a puncture wound, you follow the training out of your wilderness first aid course, pull the wound irrigation syringe and cath out of your kit and irrigate the hell out of it with saline, sterile water or potable water. If it's a huge wound, you pack it with sterile dressing material. You don't suture closed a significant puncture wound because suturing closed a puncture wound is a great way to develop sepsis and die. Let me repeat that - suturing deep wounds closed in austere environments is a great way to kill your patients. Control the bleeding, clean the wound, clean it some more, then clean it again, then close the small shit with butterflys or pack the big shit with sterile packing material and let it granulate in and heal.

The vast, vast majority of the time, suturing is done to mitigate scarring or for convenience, not to preserve life or limb. When it is done as a life saving measure, it's stuff like tying off blood vessels. If you need to ligate a vessel, you need real surgical capability or that limb will die, your patient will develop sepsis and they'll die. It's very difficult to imaging any sort of plausable scenerio where a couple of packets of suture material will be the difference between life / significant morbidity or a better outcome.

Besides, chicks dig scars.

Turns out, I want to learn alot. But I know nill.

How many inches below grade does a footing have to be in Cincinnati? The bottom of the footing not the top.

Ha, gatcha.

trick question.

An African swallow, or a European swallow? [/python]

Posted: 10/30/2009 6:20:17 PM EST

[#47]

Super Glue

Posted: 10/30/2009 6:27:21 PM EST

[#48]

Quoted:
I have packages of prolene blue monofilament. They seem to be a very fine hook and line for stitchtes.

Where can I learn how to use these packages.

I know it seems stupid for someone like me to have them but I would like to know how to "basically" use them.

I understand that infection can occure and I understand that. But when worse comes to worse. I would like to be able to use these sealed packs.

Depending on the type of wound, if it is very dirty you shouldn't close it up unless you can thoroughly irrigate it, preferably with sterile saline, and only if it is a fairly fresh wound. If you close it with bacteria/devitalized tissue inside, you risk cellulitis and/or abscess formation. You're better off placing a wet dressing directly on the wound, dry dressing on top and wrap it gently, it's called a 'wet-to-dry' dressing. Change it daily until it heals.

You have to be careful with iodine and hydrogen peroxide. You can use them with very superficial wounds, but they can kill tissue if they pool in deep wounds.

Posted: 10/30/2009 6:29:34 PM EST

[#49]

Quoted:

Quoted:
I have packages of prolene blue monofilament. They seem to be a very fine hook and line for stitchtes.

Where can I learn how to use these packages.

I know it seems stupid for someone like me to have them but I would like to know how to "basically" use them.

I understand that infection can occure and I understand that. But when worse comes to worse. I would like to be able to use these sealed packs.

Rambo stitched himself up.

I've ran out of local, so what next.

no hospital exist, but I have iodine?

E.T.A. I just whatched the viedo. I have the same 5-0 and 6-0 suture kits.

WTH?

Facts, the vast majority of suturing is performed for cosmetic reasons. Wounds which truly require suturing almost always require definitive care above and beyond sutures. Suturing is a skill that's of limited value in a field setting.

Medical care is a skill set that needs to be approached from the ground up. Start with a solid first aid or first responder course. Take a basic A&P course. (The big problem with any medical training above first aid for someone who isn't functioning as a healthcare provider is retention. A grounding in anatomy and physiology makes the 'why' behind things clearer, so it helps with retention) Then, if you're serious about wanting to be able to perform advanced procedures, look into something like Resqdoc's remote medicine class.

I was picking up what you were putting down for a while.

What your are saying though is that, when I have to deal with total melt down of every social service, my suiture kits are of no use period.

Then I have to ask, If I get a puncture wound, I die? Is there no way to clean it and close it?

Your example makes the perfect point;

If you get a puncture wound, you follow the training out of your wilderness first aid course, pull the wound irrigation syringe and cath out of your kit and irrigate the hell out of it with saline, sterile water or potable water. If it's a huge wound, you pack it with sterile dressing material. You don't suture closed a significant puncture wound because suturing closed a puncture wound is a great way to develop sepsis and die. Let me repeat that - suturing deep wounds closed in austere environments is a great way to kill your patients. Control the bleeding, clean the wound, clean it some more, then clean it again, then close the small shit with butterflys or pack the big shit with sterile packing material and let it granulate in and heal.

The vast, vast majority of the time, suturing is done to mitigate scarring or for convenience, not to preserve life or limb. When it is done as a life saving measure, it's stuff like tying off blood vessels. If you need to ligate a vessel, you need real surgical capability or that limb will die, your patient will develop sepsis and they'll die. It's very difficult to imaging any sort of plausable scenerio where a couple of packets of suture material will be the difference between life / significant morbidity or a better outcome.

Besides, chicks dig scars.

Turns out, I want to learn alot. But I know nill.

How many inches below grade does a footing have to be in Cincinnati? The bottom of the footing not the top.

Ha, gatcha.

trick question.

An African swallow, or a European swallow? [/python]

Are tampons considered sterile? Could you pack a puncture wound with one after irrigation?