A Woman's Perspective On The Times We Live In


March 9, 2013

A Stitch In Time .....

     A few weeks past, Peace-Loving Warrior and I worked to orchestrate a beginner's Suture and Wound Care class for a group of our friends and associates who were interested in knowing how to handle different open wounds.  We just happened to have a couple of friends (one a doctor, the other a veterinarian) who agreed to show us the basics of suturing.  NOTE:  Neither professional was there to promote our practicing medicine on our own.  We all knew that whenever possible, these measures should be undertaken by a medical doctor.  And I am not advocating that this post will in any way render you capable of supplying such medical care.  It is not my intention to give you a step by step of the intricate maneuvering of your hands.  That is simply too hard to render in print. I am simply telling you about my experience. 
     Our little group was mainly interested in learning this technique from a SHTF scenario.  We wanted to know when to leave a wound open and when it was necessary to close one.  We didn't want to get deep into grave or critical wound care; but be able to manage simple suturing and know how to properly care for wounds. Here is some of the information we learned:

 When to leave a wound open:                                     
 • when the wound is dirty or contaminated                 
 • when it is already infected (red, hot or swollen)      
 • when the wound is over 8 hours old                       
 • when the wound is a large or gaping injury  

When to close a wound:
• when you are sure the wound is clean
• when the wound is not infected (for sure)
• when there is not dead or burned tissue
    (you may need to cut out the bad tissue)
•  when the wound is less than 8 hours old
•  when the wound is deep
•  when skin edges are close, but not close enough
•  when wound is across a joint  

     We were advised that there are several ways in which to close a wound, including butterfly closures, Steri-Strips and surgical glue, but our group was mostly interested in learning the techniques of suturing.  We began by covering the basics as far as cleaning the wound.  We knew we could research this on our own, and most were knowledgeable that both Betadine and water, along with an irrigation tool were useful for cleaning wounds.  If Wet/Dry dressings needed to be applied, then we were instructed that water is best; maybe with a little Betadine as an antiseptic. Honey, lavendar oil and of course, triple antibiotic ointment are good supplements. Sterile gauze should be applied as the dressing, and changed at least twice a day.  And it was a no-brainer that gloves were mandatory.   
     But it was the hands-on of needle and thread that we were most interested in.  The day before, PLW and I had purchased several dozen pigs feet from the local market and we got quite a few stares as we stood in the checkout line.  But pigs feet are the closest semblance to human skin, and once everyone got past the thought of what they were working with, we settled down to our task.  And it was really simpler than I thought it would be!
     Everyone had purchased a suture kit and a box of 3-0 nylon suture thread on Amazon, at the combined price of about $25.  So we all donned our gloves, received our pigs foot and went to town.  We made an incision in our foot with a surgical scalpel.  We cleaned the area with alcohol, and injected both sides of the cut with 2 ml of antiseptic before we began suturing.  Holding the forceps in our left hand, and the needle holder in our right hand, we began about 1/4 inch from the laceration.  We lifted the skin flap and inserted the needle at a 90° angle, which minimizes the size of the entry wound and promotes eversion of the skin edges.  After the needle pierces one side of the wound, it is inserted through the opposite side and the suture needle and thread are pulled through.  In general, the 2 sides of the suture should become mirror images, and the needle should also exit the skin perpendicular to the skin surface.
As you can see, my attempt on the right is much
more even and symmetric.  I got better over time!
   Then we were shown a simple technique of tying a square knot and clipped the thread, leaving about a 1/4 inch of it hanging.  We made three to five sutures on our cut and then subjected our pigs foot to another laceration.  It didn't take more than two or three tries to get the hang of the simple suture technique.  I'm not saying that I became adept after one short lesson, but the procedure is not as mysterious or frightening as it was before I took needle in hand.  It is still a very serious situation to be faced with an open wound and the possibility of infection, but knowledge is powerful.
     We also had the opportunity to work with a stapler, and I found that much faster and simpler.  And medical staplers are also available online.  All in all, it was a positive experience and worth the time to become familiar with the instruments.  I would recommend that you research this yourself, and if possible, find a medical professional who is willing to show you the technique.  You can also watch videos on the procedure at www.doomandbloom.net.  Of course, PLW is hoping he never has to be the recipient of my suturing skills, but at least I know it is something I can do if faced with an emergency and no doctors available.
   
Luke 5:15     "Yet the news about him spread all the more, so that crowds of people came to hear him and to be healed of their sicknesses." 


5 comments:

  1. Very nice summary! I hope others are paying attention and learning to do things to the best of their ability to be able to take care of themselves and their family without relying on the medical system for when things collapse.
    CZ

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  2. Belle,

    You mentioned something in this article about using a stapler and I just wanted to make a quick comment on the use of a stapler. Last year we had an accident on our farm on shearing day (first shearing accident ever) which left one of our animals with a six inch, clean cut on the side of the abdomen. It was basically skin deep though. No muscle. We called the vet out right away and he brought along with him a stapler that came in a package and he and I went to work as others watched. We did the usual clean up with diluted Nolvasan and then took this handy device, brought the two horizontal edges together, just meeting, not overlapping and came in a quarter inch from the beginning of the cut on one side and worked our way across placing the staples less than a half inch apart, and ending with the last staple about a quarter inch from the final edge as was in the beginning. It was clean, quick and VERY efficient.I kept close watch for any infection daily and ended up removing the staples at ten days and honestly, you'd never have known that cut was there! I got right on board and added one to our personal care first aid and one for the barn. I would suggest that everyone have betadine and nolvasan available along with this handy gadget. I also ordered from my vet the small device that removes the staples afterwards, which I'm glad that I thought about, otherwise it would have been a real bear to get those tiny staples removed while you had a dancing animal moving around! Good investment to procure. As we know, it's best to know the hands on technique to truly suture if needed because the stapler will not be the answer for every situation.

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    1. Thanks for the great endorsement on the stapler .... and the very important reminder to also get the staple remover. There is no good way to remove the staples without this piece of equipment. And it's always nice to get a first hand report on someone actually putting these devices into use. Very helpful!

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  3. Well... after seeing your article, I thought we were prepared for future events. After all, my wife is a nurse and so that area is covered ! Or so I thought - your article left me realizing that even if one part of the team is skilled in an area, it behooves the team for everyone to have some capabilities in most areas. Thanks for the reminder - guess we'll go and get some pig's feet !
    RB

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    1. Yes! The doctors who guided us said it would be very difficult to suture yourself, if no one else was knowledgeable about the procedure. So your comment should open a lot of eyes. Thanks for your thoughts!

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