Suturing

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coastie

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Does anyone know if there is a class I can take that includes suturing? My buddy just sent me some sutures and I have no idea how to properly use them. I saw some Utube vids but there is nothing like real use. I suppose I could cut up the cat but my kids will be pissed.
 
As a Navy Corpsman, we used pigs feet to practice suturing but cats work well too.[grin] There are several ways to suture and I cannot remember much of it anymore, last time I sutured was in 1999. I can look through my Corpsman pubs and possibly scan something into a PDF if your interested.
 
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1. , Don't.

I've also Practiced many times on pigs feet. Sutured someones tighe under supervision of a PA and Doc.

2. Please Don't.

You can really eF someone up. Different types of sutures, thicknesses ect... sometimes you leave the wound open, sometimes from the inside out.... Meds? Irrigation? Infection control?
 
OB1Kenobi said:
1. , Don't.

I've also Practiced many times on pigs feet. Sutured someones tighe under supervision of a PA and Doc.

2. Please Don't.

You can really eF someone up. Different types of sutures, thicknesses ect... sometimes you leave the wound open, sometimes from the inside out.... Meds? Irrigation? Infection control?
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This^

http://www.brooksidepress.org/Products/Operational%20Medicine/DATA/operationalmed/Manuals/HM32/Chapter04/Chapter04.htm#ch04s

Before discussing the methods of coaptation (bringing together), some of the contraindications to wound closing should be described:

  1. If there is reddening and edema of the wound margins, infection manifested by the discharge of pus, and persistent fever or toxemia, DO NOT CLOSE THE WOUND. If these signs are minimal, the wound should be allowed to "clean up." The process may be hastened by warm, moist dressings, and irrigations with sterile saline solutions. These aid in the liquefaction of necrotic wound materials and the removal of thick exudates and dead tissues.
  2. If the wound is a puncture wound, a large gaping wound of the soft tissue, or an animal bite, leave it unsutured. Even under the care of a surgeon, it is the rule not to close wounds of this nature until after the fourth day. This is called delayed primary closure and is performed under the indication of a healthy appearance of the wound. Healthy muscle tissue that is viable is evident by its color, consistency, blood supply, and contractibility. Muscle that is dead or dying is comparatively dark and mushy; it does not contract when pinched, nor does it bleed when cut. If this type of tissue is evident, do not close the wound.
  3. If the wound is deep, consider the support of the surrounding tissue; if there is not enough support to bring the deep fascia together, do not suture because dead (hollow) spaces will be created. In this generally gaping type of wound, muscles, tendons, and nerves are usually involved. Only a surgeon should attempt to close this type of wound.
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As someone else who's actually done it before and after being an EMT and not suffered any permanent damage, just use common sense. Don't wait hours or days to do it. Clean it the wound, stitch it up right away with sterile tools.

If the wound will readily close (think like a papercut, but obviously bigger) you're good to go assuming you didn't kill a ligament/tendon. Do a function check before starting. If you've lost motion or feel numbness that extends beyond the directly effected area, go see a doc you hit something important.

If the wound is big enough that it does not readily close do not stitch it yourself. Go see a doctor. i.e. if you have to tell your buddy to put his beer down and hold it together while you stitch it, you're making a mistake.

Last and most important. Learn the correct knot tying technique. It's fast and holds strong. This is the best use of YouTube vids and the pig ananlog.

I don't discourage self help.
 
xtry51 said:
As someone else who's actually done it before and after being an EMT and not suffered any permanent damage, just use common sense. Don't wait hours or days to do it. Clean it the wound, stitch it up right away with sterile tools.

If the wound will readily close (think like a papercut, but obviously bigger) you're good to go assuming you didn't kill a ligament/tendon. Do a function check before starting. If you've lost motion or feel numbness that extends beyond the directly effected area, go see a doc you hit something important.

If the wound is big enough that it does not readily close do not stitch it yourself. Go see a doctor. i.e. if you have to tell your buddy to put his beer down and hold it together while you stitch it, you're making a mistake.

Last and most important. Learn the correct knot tying technique. It's fast and holds strong. This is the best use of YouTube vids and the pig ananlog.

I don't discourage self help.
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Me neither. I didn't know EMT's did sutures... [laugh]. This isn't self help, this is retardation.

You pretty much nailed it... Except sub sutures for dermabond (sp) or wtf ever they call it these days.


i'd sooner prefer quick clot than let someone w/o a PhD, PA, NP or RN attached to thier name stitch me up. Either eway i'm ****ed...
 
I guess I will be the first to ask why you wanna know this? haha In all seriousness is it for your line of work? or a just incase emergency thing
 
The reason to know how is simple. It saves money and a trip to the ER. Why spend a few hundred dollars and waste the hours when you can do it yourself in 15 minutes?

I don't think the people wanting to know have any delusions of sewing limbs back on or knitting up chainsaw wounds. This is only useful for medium depth clean edge cuts. Otherwise if you're not going to see a doc the best thing to do is leave it open, keep it clean with frequent bandage changes and take antibiotics if you have any. It'll heal this way, albeit with an ugly big scar. People did survive for thousands of years without doctors and they did it by doing shit themselves.

And I only stitch myself, family and friends. Never did while on the job as an EMT [laugh]
 
This is two fold. I like to learn new things and it could be a good thing to know in the future. I dont plan on doing it unless there isnt another option. I figure that is why I pay for health insurance and there isnt a chance in hell my wife would let me near anyone, even the cat, if there were other options. Having said that I would rather not have my first attempt at suturing be on my kid after disaster strikes.
 
coastie said:
This is two fold. I like to learn new things and it could be a good thing to know in the future. I dont plan on doing it unless there isnt another option. I figure that is why I pay for health insurance and there isnt a chance in hell my wife would let me near anyone, even the cat, if there were other options. Having said that I would rather not have my first attempt at suturing be on my kid after disaster strikes.
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+1
 
coastie said:
This is two fold. I like to learn new things and it could be a good thing to know in the future. I dont plan on doing it unless there isnt another option. I figure that is why I pay for health insurance and there isnt a chance in hell my wife would let me near anyone, even the cat, if there were other options. Having said that I would rather not have my first attempt at suturing be on my kid after disaster strikes.
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This.
 
im a doc and have loads of experience suturing, i wouldn't suggest saving a couple hundred of dollars as a reason for self suturing.

sterile environment, equipment, anesthetics, technique, scarring, function, infection, limb loss, sepsis, amputation... that's an incomplete list.

still worth it to you? it's not all about closing the wound.
 
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gigabit said:
im a doc and have some loads of experience suturing, i wouldn't suggest saving a couple hundred of dollars as a reason for self suturing.

sterile environment, equipment, anesthetics, technique, scarring, function, infection, limb loss, sepsis, amputation... that's an incomplete list.

still worth it to you? it's not all about closing the wound.
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that just brought this post back to a serious tone...all more than valid points obviously. But I see the OP's reasoning for wanting to learn just in case as you never know what life will throw at you and where etc.
 
xtry51 said:
The reason to know how is simple. It saves money and a trip to the ER. Why spend a few hundred dollars and waste the hours when you can do it yourself in 15 minutes?

I don't think the people wanting to know have any delusions of sewing limbs back on or knitting up chainsaw wounds. This is only useful for medium depth clean edge cuts. Otherwise if you're not going to see a doc the best thing to do is leave it open, keep it clean with frequent bandage changes and take antibiotics if you have any. It'll heal this way, albeit with an ugly big scar. People did survive for thousands of years without doctors and they did it by doing shit themselves.

And I only stitch myself, family and friends. Never did while on the job as an EMT [laugh]
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Saving money is a terrible reason to try to suture yourself for so many reasons, detailed by gigabit below.

People may have survived without doctor for thousands of years; however, there's a reason why life expectancy now is 3 times longer than it was in those days - and why infected small wounds don't lead to death nearly as much.

coastie said:
This is two fold. I like to learn new things and it could be a good thing to know in the future. I dont plan on doing it unless there isnt another option. I figure that is why I pay for health insurance and there isnt a chance in hell my wife would let me near anyone, even the cat, if there were other options. Having said that I would rather not have my first attempt at suturing be on my kid after disaster strikes.
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If you must practice, do so on oranges or bananas, but get actual suture and actual suturing instruments, which are expensive.

gigabit said:
im a doc and have some loads of experience suturing, i wouldn't suggest saving a couple hundred of dollars as a reason for self suturing.

sterile environment, equipment, anesthetics, technique, scarring, function, infection, limb loss, sepsis, amputation... that's an incomplete list.

still worth it to you? it's not all about closing the wound.
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I agree completely. I don't suture that often - a few times a month, but it's not as simple as it seems.
 
People may have survived without doctor for thousands of years; however, there's a reason why life expectancy now is 3 times longer than it was in those days - and why infected small wounds don't lead to death nearly as much.
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Life expectancy is a very poor measure as it includes everyone born in the calculation. Most sites will list the life expectancy in 1750 to be in the mid 30's. However, there was a 65% infant mortality rate at that point so this figured in to the average. Even in the 1200's when life expectancy was in the low 40's, a person who lived to be 40 could expect to actually live into their 60's. 1400-1500 those who lived to 48 were likely to reach age 69. The biggest factor in life expectancy is infant mortality.


so.... back to topic
 
PennyPincher said:
Life expectancy is a very poor measure as it includes everyone born in the calculation. Most sites will list the life expectancy in 1750 to be in the mid 30's. However, there was a 65% infant mortality rate at that point so this figured in to the average. Even in the 1200's when life expectancy was in the low 40's, a person who lived to be 40 could expect to actually live into their 60's. 1400-1500 those who lived to 48 were likely to reach age 69. The biggest factor in life expectancy is infant mortality.


so.... back to topic
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Doesn't change the fact that the morbidity/mortality rate from what are now considered minor/moderate wounds has gone way down.
 
I think you should pay deference to your screen name and learn to suture with a sail needle, shot line, and beeswax.

Or listen to the actual Doctors that posted on this thread. They probably know what they're talking about much more than a Boatswain's Mate that really, really, really wants to see someone stitch themself up with a sail needle and shot line.
 
MConnelly2 said:
I think you should pay deference to your screen name and learn to suture with a sail needle, shot line, and beeswax.

Or listen to the actual Doctors that posted on this thread. They probably know what they're talking about much more than a Boatswain's Mate that really, really, really wants to see someone stitch themself up with a sail needle and shot line.
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Thank you for your insight and wisdom in contributing to this thread.
 
MConnelly2 said:
I think you should pay deference to your screen name and learn to suture with a sail needle, shot line, and beeswax.

Or listen to the actual Doctors that posted on this thread. They probably know what they're talking about much more than a Boatswain's Mate that really, really, really wants to see someone stitch themself up with a sail needle and shot line.
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Wow Dick much?
 
I work in the OR and I can stitch also. Even under the best conditions and by the most experienced, things happen and they get F'ed up. Even though I can do it, it's the very last thing I would want to do. I'd pack it and hope it granulates in.
 

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