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Suturing Wounds When Necessary

One of the most important survival skills you will ever learn is how to properly administer first aid. This is something I have given considerable thought to because I live forty-five minutes away from town, and the hospital there is only so-so. But in all honesty, the more we can do at home, the better. Apart from the distance involved, which could be the difference between addressing something quickly or facing the consequences, the quicker we all rely less on modern conveniences, the better off we will be.

We eat off the land; many of us have livestock and you may even hunt for your own food. If you are concerned with what goes in your body, caring for it in an emergency is necessary for this way of life. This includes treating and suturing open wounds. Sure, most of our first aid kits are stocked with supplies for suturing, but using those supplies is not as simple as opening up a bandage and putting it on. Improper suturing can often times be more harmful than actually allowing the laceration to close on its own. Understanding the mechanics of suturing and applying them correctly can mean the difference between life and death for the individual with an injury.

Deciding When to Suture

In most cases, the best option of closing a wound is the least invasive one. Many lacerations can be closed with steri-strips, glue, or other similar techniques. Sutures should only be used as a last resort. The primary goal of any wound repair should be to clean and bandage the wound and then allow it to close on its own. The human body is amazingly adept at healing when given the chance. However, when the wound will not stay together with strips or glue or is bleeding too profusely, suturing may be the most sensible decision.

Excellent information regarding the basics of suturing in extreme situations can be found in Part One of this four-part Suturing Under Austere Medical Conditions video series.

Suturing Supplies

Once you have decided to suture a wound, specific criteria must be met in terms of the actual supplies. Ideally, your medical kit will include a suturing kit stocked with all the correct items you will need. However, you should know what pieces are absolute necessities to ensure you have them well stocked and on hand.

  • Clean water
  • Betadine
  • Needle Driver
  • Irrigating Syringe
  • Suture material
  • Gloves

An important note must be made regarding suture material. If you are creating your own medical kit, you will need to ensure you have appropriate suturing material. There are multiple varieties of needle shapes, needle types, and suture threads. Most common muscle tissue, arm, and leg wounds can be closed with suture thread size 4 and 5. For more delicate areas like the mouth, suture size 2 or 3 is preferred. Most wounds can be closed with thin, curved needles. Keeping a variety of these suture materials in your kit will make sure you have the supplies you need if the situation calls for them.

Part Two of the Suturing Under Austere Medical Conditions video series discusses the most basic supplies that should be included in your kit.

Cleaning the Wound

In every instance of dealing with a skin lacerations, cleaning the wound is the first and most critical step. If the wound is not cleaned, infection will undoubtedly set in, causing more severe complications. In most cases, simple, clean water should be used. Although often referred to, saline is not necessary to clean a wound. As long as the water is clean and pure, it will be fine. Occasionally, a wound will show evidence of debris. If that is the case, diluted Betadine must be used to clean the wound. Pour a small amount of water into a clean cup or bowl and add several drops of Betadine until it looks similar to weak tea. This will be the perfect diluted amount to irrigate with. Once the cleaning solution is determined (either water or diluted Betadine), fill the irrigating syringe and cleanse directly into the wound. Not only will this allow for less wasted water, but the syringe offers more direct cleansing to knock out any unwanted elements.

Beginning the Process

Once bleeding has been stopped or slowed, and the wound has been cleaned, suturing can begin. It is imperative you keep the injured area as clean and sterile as possible before, during, and after. Although that is often difficult in survival situations, it will go a long way in minimizing the risk of infection. One way to accomplish this is to wear sterile gloves and to have all materials cleaned, prepared, and ready to go before you begin the procedure. This will reduce the amount of time you will actually be handling the wound. Orient the wound so that it is parallel to your body to also allow you to work quicker.

Part Three of the Suturing Under Austere Medical Conditions video series explains how best to start the suturing process.

Suturing the Wound

In its most basic form, a suture is simply a series of knots tied over an open wound to enable and aid the skin to close properly. A variety of knots can and have been used, each of them specifically suited for a certain type of injury. However, in a survival situation, the goal should always be health. Learning the most basic form of knots will allow you to close the wound properly.

This basic suture technique is shown in Part Four of the Suturing Under Austere Medical Conditions video series.

Basic Steps

Although it may seem like a large amount of information, suturing a wound can be a simple process, particularly if you have practiced for it. Just remember these key basic steps:

  1. Observe the wound and determine the best way to close it.
  2. Put gloves on to minimize potential infection.
  3. Clean and irrigate the wound, removing any foreign matter or debris.
  4. Thread the curved needle, or open your suture kit and grasp the needle with your needle driver.
  5. Start at the center of the laceration and work outwards.
  6. Leave approximately 1/8 an inch between each stitch.
  7. Bandage the wound to minimize later infection.

After the Suture

Aftercare is a unique element in survival medicine. Although patient comfort is definitely important, the primary focus here is avoiding infection. Regularly changing bandages, which means twice a day, keeps the laceration clean and allows you to check for any sign of infection. If the wound does not appear to be healing, or if there is any infectious evidence, it may be necessary to reopen the wound and determine if any foreign debris remained inside that you may have missed.

Having the best medical kit in the world will not do you any good if you do not understand how to use it. If you are going to be in the position to possibly treat or suture any sort of injury it is imperative you are intimately familiar with the contents of your kit and know how to use each and everything. Practice your suture technique as often as you can. Hopefully you will never have to use this skill, but it is always better to be prepared.

©2012 Off the Grid News

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3 comments

  1. Suture sizes are opposite the number sequence 3-0 is bigger than 4-0 faces need 5-0 or 6-0 preferably on a P3 needle (small and leaving a very small puncture) Proline and Ethilon suture are basically nylon fishing line. It is non absorbable. Vicryl is a synthetic absorbable that works well in mouths. Gut sutures are the old standard absorbable but cause some inflammation at the site.
    Put the needle into the skin at a right angle- straight in, so that when you pull through underneath and come up through the other side, it everts the skin slightly. Example- Push the tips of the fingers of your hands together and push hard- notice how the tips of your fingers push up and the fleshy tips push into each other. That is what you want the edges of the cut to do. There should be a slight ridge along the cut when you are done. This puts the raw surfaces in contact with each other so healing can take place with some strength. Skin touching skin won’t hold much. Skin won’t grow to skin. Don’t pull the sutures too tight. It will strangle the tissue by cutting off the circulation. Just $.02 from an old er doc.

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