Stitching Wounds In Emergency Situations
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Thread: Stitching Wounds In Emergency Situations

  1. #1
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    Arrow Stitching Wounds In Emergency Situations

    For the professionals here, please critique this article and add or subtract any information you know requires addressing.

    From the article:

    "Any wound that you intend to suture should be cleaned, re-cleaned and then cleaned again. I can’t stress this enough."

    "If a wound is already suppurating, producing pus, or had debris in it that cannot be removed it should be left open. In addition, animal and human bites should not be sutured. Closure of these wounds will cause more harm than good and can lead to septicaemia, gangrene and even death."

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    Disclosure: The information in this article is for informational purposes only. Nothing contained on this web site should be construed nor is intended to be used for medical diagnosis or treatment. Consult your physician or other qualified health care providers with any questions regarding medical care.
    Quote Originally Posted by Deanimator View Post
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  3. #2

    Stitching Wounds In Emergency Situations

    I agree with the quoted text completely. If you suture a wound closed without a totl cleaning and debriedment, it is likely to produce an environment friendly to anaerobic bacteria, like gangrene.
    Same for most punctures, including animal bites; the puncture channel closes and traps bad bacteria and gives anaerobes an environment that promotes growth.

  4. The most important thing is to keep the wound clean. Don't suture if not clean; in a healthy individual even urine can be used on a wound to clean it.
    Redness should diminish in time and color saturation over time. If not think infected. Air circulation is important to healing so don't wrap it too tight and let've it covered all the time

    Deep wounds that you cannot suture cleanand cover with gauze. Change and irrigation of the site with normal saline (0.9 percent) a couple times a day


    just 'bout the action boss...

  5. #4
    Large and / or deep open wounds do well when packed with "iodiform" gauze (various size gauze pads & strips with an iodine-based bacteriostatic agent). It breaths well, keeping it oxygenated, and permits it to heal from the bottom up. When I worked General Surgery at Cp. Lejeune, we had a 12yo dependent come in with a shotgun wound to the abdomen (he fell out of a tree stand holding a loaded shotgun). It took out a kidney and a mass of tissue, but after it was cleaned out surgically and packed daily with Iodiform (the post-op wound was large enough to put your fist without touching the sides), it healed over about six weeks to the point he could be discharged to outpatient care.
    Packing works well; but it has to be done often enough that the tissue doesn't grow into the mesh of the packing material.

    Peroxide is a Good Thing too. It begins to decay once you've opened the bottle, so it's better to have a bunch of little bottles than one or two large bottles.

  6. #5
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    Quote Originally Posted by ScottMac View Post
    Large and / or deep open wounds do well when packed with "iodiform" gauze (various size gauze pads & strips with an iodine-based bacteriostatic agent). It breaths well, keeping it oxygenated, and permits it to heal from the bottom up. When I worked General Surgery at Cp. Lejeune, we had a 12yo dependent come in with a shotgun wound to the abdomen (he fell out of a tree stand holding a loaded shotgun). It took out a kidney and a mass of tissue, but after it was cleaned out surgically and packed daily with Iodiform (the post-op wound was large enough to put your fist without touching the sides), it healed over about six weeks to the point he could be discharged to outpatient care.
    Packing works well; but it has to be done often enough that the tissue doesn't grow into the mesh of the packing material.

    Peroxide is a Good Thing too. It begins to decay once you've opened the bottle, so it's better to have a bunch of little bottles than one or two large bottles.
    Really? I've never heard of this before (probably b/c I don't pay attention), good to know!
    Quote Originally Posted by Deanimator View Post
    [*]Don't be afraid to use sarcasm, mockery and humiliation. They don't respect you. There's no need to pretend you respect them.
    Operation Veterans Relief: http://www.opvr.org/home.html

  7. #6
    General consensus is about six months after it's opened.
    If it's "expired" it won't work but it won't do any damage either.
    Put it on the cut, if it bubbles, it's working, at least to some degree.

  8. #7
    ...And today's handy tip is: Aluminum Foil.
    It can be sterilized, or used as "sanitary" off the roll (and repackaged for Kit use).
    It makes a good water-proof covering
    It makes a good cover for burns and passes cooling agents (water, freon, cold packs, etc) without exposing the burn or wound directly.
    It makes a good cover for "sucking chest wounds" (pneumothorax)
    Folded to a few layer and curved, it makes a good finger or wrist splint (I prefer layered "Chicken wire" or 1/4" hardware cloth for ad hoc splinting larger things)
    Layered it can be used to create a shield and support for punctures with the object in-place
    It can be used as a waterproof covering for other stuff
    Lots more, limited only by your imagination!

  9. I would recommend a plastic or rubber like wrap for an occlusive dressing to treat open pneumothorax (open/sucking chest wound) but as scott suggested you could use foil for a hasty dressing. I would recommend Halo seals personally.

    I carry black coated safety pins in the event of severe laceration or disembowelment, they work well to hold in guts and misc items from the torso. I use these frequently in my combat kit in theater.

  10. The highlighted quote is so good! Perfect advice for anyone. I would suggest keeping the wound clean before suture. Otherwise, great article!!

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