Suture kits, and why you need them.

[Dead Duck]

That's been a predicament I've thought of.

Needing stitches on my sewing hand or on my backside that I can't reach.
You're a good son to be near by and available.
(Not throwing-up is also a plus)

Hope all his nerves are not affected.

 

[jmiller676]

I would like to point out a few things mentioned here... only nit-picking though....

You in-correctly used the word sterilized a few times. Use the word clean, it's more accurate and makes it sound like you know what you are talking about if someone is to follow your lead. There is a huge difference between the two.

Never suture a would past 6hrs of the injury

If possible use a monochrome vs polychrome suture (single thread like most fishing lines) not a braided suture.

NEVER EVER EVER use any form of chemical anticoagulant. Period.
I am trained an I won't touch the stuff.

There are several styles and ways to suture... but as you have demonstrated just because one way it the "way" to do it....doesn't make it the only way.

Please keep us up to date on the healing process and your successes or how you would do things differently as you see fit.

The hand is a tough place to heal since its used so much, good luck.

And if I haven't said it yet... Good Job!

Thank you for the tips, I stopped by over lunch today and he said his hand is feeling good (no pain) and the cut looked like it was "bonding" this morning when he changed bandages cleaned, and put more antibacterial on it.

 

[jmiller676]

That's been a predicament I've thought of.

Needing stitches on my sewing hand or on my backside that I can't reach.
You're a good son to be near by and available.
(Not throwing-up is also a plus)

Hope all his nerves are not affected.

At first seeing a deep cut like that is amazing, the actual fibers of the muscle is what got me a bit, I just had to remember to breathe so I didn't pass out. Things like that don't usually get me but when blood is gushing from your fathers hand it's a different perspective.

 

[Ted]

NEVER EVER EVER use any form of chemical anticoagulant. Period.

I understand that this is essentially cauterizes, and requires burn treatment to repair the affected area. Correct me if I'm wrong.

 

[Icarry2]

Yep, just like that. I don't find it complicated. Out of curiosity have you ever had to suture anything?

Yes

Do you have pictures of your fathers hand? I think many would like to see.

Did you have local anesthetic or the grit your teeth method?

Thanks,

TJ

 

[jmiller676]

Yes

Do you have pictures of your fathers hand? I think many would like to see.

Did you have local anesthetic or the grit your teeth method?

Thanks,

TJ

Didn't take pictures, we were more concerned with getting it stitched and to stop the bleeding as quickly as possible, and it was the grit your teeth method along with "**** that burns" and "**** that hurts" methods as well.

 

[redneckmedic]

I understand that this is essentially cauterizes, and requires burn treatment to repair the affected area. Correct me if I'm wrong.

The chemical process causes an exothermic reaction destroying all tissues that are used in the process. Major surgery is needed the reconcile the area, with a rehab time uncertain for debridement of the inside wound cavity. Infection is outrageous and success rate is really unknown. Not to mention the creation of throbis in blood vessles. The window to actually get me to use this is sooooo small that by the time I thought to use it, get to my kit, open it, apply it, and stop the bleeding, the patient would have a front row seat hovering over their own body.

The debate on whether its OK to destroy tissues to save a life is fair, however the gross chances of mis-use, conpletely out weight the purchase for me.... and I'm trained.

The military removed them from their medic (to the best of my knowledge), metropolitan 911, ERs, trauma centers and OR's don't use them.... why the heck would Dick's market them to your weekend warrior mountain biker?

/rant

 

[jmiller676]

The chemical process causes an exothermic reaction destroying all tissues that are used in the process. Major surgery is needed the reconcile the area, with a rehab time uncertain for debridement of the inside wound cavity. Infection is outrageous and success rate is really unknown. Not to mention the creation of throbis in blood vessles. The window to actually get me to use this is sooooo small that by the time I thought to use it, get to my kit, open it, apply it, and stop the bleeding, the patient would have a front row seat hovering over their own body.

The debate on whether its OK to destroy tissues to save a life is fair, however the gross chances of mis-use, conpletely out weight the purchase for me.... and I'm trained.

The military removed them from their medic (to the best of my knowledge), metropolitan 911, ERs, trauma centers and OR's don't use them.... why the heck would Dick's market them to your weekend warrior mountain biker?

/rant

I am confused now, you use a "quick clot" type sponge rather than the chemical or is it the fact that the time in which to deploy the quick clot is longer than the time you have left to live, in a dire situation? I guess what I am asking is, what is your preferred method to stop or treat traumatic bleeding

 

[LockStocksAndBarrel]

Very valuable information.

Thanks RNM.

 

[spencer rifle]

Any advantages/disadvantages to super glue, especially if you were not planning to suture it up yourself?

We have needles, suture and one of these in our kit:
[ame=http://www.amazon.com/gp/product/B006FJEVIM/ref=oh_details_o09_s00_i00]EMT EMS Surgical Skin Stapler w/35 {wide} Staples and Remover, Sterile: Amazon.com: Industrial & Scientific[/ame]

 

[Dragon]

The chemical process causes an exothermic reaction destroying all tissues that are used in the process. Major surgery is needed the reconcile the area, with a rehab time uncertain for debridement of the inside wound cavity. Infection is outrageous and success rate is really unknown. Not to mention the creation of throbis in blood vessles. The window to actually get me to use this is sooooo small that by the time I thought to use it, get to my kit, open it, apply it, and stop the bleeding, the patient would have a front row seat hovering over their own body.

The debate on whether its OK to destroy tissues to save a life is fair, however the gross chances of mis-use, conpletely out weight the purchase for me.... and I'm trained.

The military removed them from their medic (to the best of my knowledge), metropolitan 911, ERs, trauma centers and OR's don't use them.... why the heck would Dick's market them to your weekend warrior mountain biker?

/rant

Could you tell us which chemical coagulants you're referring to? In my research on Quik Clot I've found nothing like what you're describing when dealing with their newer line of products.

 

[jmiller676]

Here is a photo from this afternoon.

 

[Survivalcookie]

No, its like sewing... Needle in one side, through cut to other side, square knot on top of square knot. It's simple really, and this isn't the first time we done this. May not be to "standards" but it works.

I was told you can practice on a pigs foot...which make sense it is like human skin. In fact our next MSG someone is bring pigs feet and a nurse is going to teach us to suture.

 

[Liberty1911]

This wouldn't really work well for me unless I could do it myself.

Every time my wife sees blood or anything like this in real life, she gets queasy and says "I think my legs are going to pass out."

 

[fatguyinalittlecoat]

Pleas take into consideration the mechanism of injury, time from injury occurring, etc. before thinking just suturing will take care of everything. Depending on who you ask, there is a 12 hour window to suture wounds, and the treatment does not begin or end there as far as prepping the wound and managing healing.

Is your father up to date on tetanus?

Kudos to you being prepared and handling business, just remember the devil is in the details when it comes to these things. I have seen simple wounds turn south because of seemingly unrelated issue likes diabetes complicating recovery. I'm not being dramatic or hating just wanting to be realistic.

Jeff

 

[redneckmedic]

Quick clot is a brand name, it is one of a few chemical coagulants. You won't read much about the negitive outcomes for a few reasons, they're data isn't showing the full picture, its from an exposed vascular wound in a controlled enviroment. On sedated patients.

Controlling bleeding hasn't changed in years...

Direct pressure
Elevation
Arterial pressure
Tourniquet

In reference to the post above... 12 hrs post injury is way too long to wait to use sutures, the tissues have lost all integrety to hold taught by then.

 

[Ted]

Quick clot is a brand name, it is one of a few chemical coagulants. You won't read much about the negitive outcomes for a few reasons, they're data isn't showing the full picture, its from an exposed vascular wound in a controlled enviroment. On sedated patients.

Controlling bleeding hasn't changed in years...

Direct pressure
Elevation
Arterial pressure
Tourniquet

In reference to the post above... 12 hrs post injury is way too long to wait to use sutures, the tissues have lost all integrety to hold taught by then.

I am aware that there are many physicians that won't suture post 3-4 hour injury, but the closure of noncontaminated wounds may be successful up to 12 hours, or even 24 hours in healthy patients with a clean laceration of a vascular area, such as the face and scalp.

Such is subject to the discretion of the attending.

 

[redneckmedic]

I am aware that there are many physicians that won't suture post 3-4 hour injury, but the closure of noncontaminated wounds may be successful up to 12 hours, or even 24 hours in healthy patients with a clean laceration of a vascular area, such as the face and scalp.

Such is subject to the discretion of the attending.

Post 6+ hours has nothing to do with infection. It has to do with how the skin breaks down, cells leak fluid and lose integrity. By all means each clinician has their own set of standards, I'm speaking in terms of human pathophysiology and don't forget, you are offering medical advice on an open forum to a group of medically untrained folks. Try to see the forest through the trees here.

 

[Meister]

I buy a new lot of suture kits every year. I'm not certain they ever go bad, but I'm not taking any chances. If anyone wants to practice with my old kits (cookie) let me know and I'll send you a few 1-0 to 5-0. I keep some old ones around for repairing gear and making clothing repairs. Strips work well and are fairly painless, superglue takes superhuman pain threshold to endure the application process.

Chem Coags are the devil. I refuse to use them or even keep them around after seeing pictures of the damage they cause. It's only a matter of time and litigation before it's withdrawn from the market. In a SHTF situation, the ability to save someone long enough to watch them die later of infection is not beneficial to the team or group.

 

[Ted]

Post 6+ hours has nothing to do with infection. It has to do with how the skin breaks down, cells leak fluid and lose integrity. By all means each clinician has their own set of standards, I'm speaking in terms of human pathophysiology and don't forget, you are offering medical advice on an open forum to a group of medically untrained folks. Try to see the forest through the trees here.

I'm aware of the pathophysiology of your statement; I merely wished to expound upon your statement as it not being an absolute.

Such is the reason why I qualified my remarks. Medicine is an art, as well as a science.