suture kit

[Buckeye0311]

Does anyone know where to get a good suture kit for a fair price?? Thanks!!

[Bsully]

Suture kits (http://www.google.com/search?q=suture+kit&ie=utf-8&oe=utf-8&aq=t&rls=org.mozilla:en-US:official&client=firefox-a#q=suture+kit&hl=en&client=firefox-a&hs=t0U&rls=org.mozilla:en-US:official&prmd=ivns&source=univ&tbs=shop:1&tbo=u&sa=X&ei=s6WXTYKGJsbXgQef7pHYCA&ved=0CDcQrQQ&biw=1683&bih=924&fp=33595b162ddf8fea)

[MIKE G]

I dont know your background but do you know how and when to suture vs when it is a bad idea to suture? There are some pretty solid guidelines about suturing time frames, dirty wounds, etc and other ways to manage wounds besides suturing. Not to mention most numbing agents are Rx so you would be suturing with no pain management. That is just the tip of the iceberg...

I am all about people having cool guy tools as long as they have the knowledge to go with it.

[MIKE G]

Quick follow up, for anyone that wants to start learning to suture I recommend the following text: http://www.amazon.com/Wounds-Lacerations-Emergency-Care-Closure/dp/032302307X

It is the standard by which most physicians are trained and it is the text I was trained out of as a remote duty Medic. That being said, it is still only a book and you will be teaching yourself who is occasionally the biggest fan and worst critic. I dont know of any groups that train non-medical personnel in suturing but you may try finding a vet or doc to teach you after some self study with this book.

Some methods for practice, get some suture material and some dish sponges. I have used both the two sided (brillo on one, sponge on the other) and the single piece of sponge. Make cuts and stitch it up. Two sided allows you to practice multi-layer repair.

Remember though, in the field, sometimes it is better to let a wound heal by secondary intention (not suturing). This will actually reduce infection if you provide wound care appropriately and almost certainly reduce the chances of an abscess.

Hope that helps,

[Pathfinder Ops]

I dont know your background but do you know how and when to suture vs when it is a bad idea to suture? There are some pretty solid guidelines about suturing time frames, dirty wounds, etc and other ways to manage wounds besides suturing. Not to mention most numbing agents are Rx so you would be suturing with no pain management. That is just the tip of the iceberg...

I am all about people having cool guy tools as long as they have the knowledge to go with it.

Mike G hits this square on.

We have a suturing module in our TOMS-B course and spend a lot of time addressing the myriad of considerations around the suturing topic before we ever get students into the actual hands on lab.

Pro's vs Con's, not to mention the acquisition and storage of the items required for this; be they pharmaceutical or hardware or..... and the list can go on.

Good luck, get some serious training, and be prudent.

[Hmac]

I taught my TAC Team medics how to suture using pig's feet and how to tie knots using the venerable surgical tubing knot-board. It's no big deal. I did that because the scenario at the moment, whether it be training or an incident, might be facilitated by that. We had a protocol with rigid rules about when they could close those wounds. OTOH, there is little or no need for our hospital paramedics to suture wounds and they are prohibited.

[Buckeye0311]

Thanks for all of the replys and heads up. I am currently a medical student and just had my first suture lab, that pigs foot will thank me:D. Right now I know enough to know that I am just crawling with this knowledge, but I figured that I would get a kit so that if I was put into a worse case position I could help some one. I of course would only provide care, in this case sutures, if there were absolutely no other options. Just looking for a kit to add to my "oh shit kit" that rides in my truck every day.

[Hmac]

You don't mention what year medical student you are, but I can assure you that you will get suturing experience ad nauseum on your Surgery rotation in your third year and in any subsequent ER electives. Bear in mind that what you teach yourself now you may well have to unlearn later when your resident teaches you how to do it right, and while you're learning the practical fundamentals of wound management and wound healing.

As to "helping someone"...you mean like, suturing someone up in a car accident or something? No...you are not yet allowed to perform miracles on an unsuspecting public without supervision. Be patient. Learn the trade first. The public doesn't need your help yet.

[Buckeye0311]

Just to clarify, I do not want a suture kit so that I can run out and stitch someone up or be anything more than prepared for any situation. I also understand that attempting to suture a pt with out numbing agents would...well suck to say the least. I just want to gather supplies so that in the future when I have a much more advanced skill set I can make a difference if need be.

Mike G that book you mentioned looks interesting. I think I will pick it up and read it this summer when I have free time. Thanks for the info!

[Hmac]

By the time you have sufficient skills, you will have ready access to virtually all the tools and supplies, including local anesthetic, that you need to assemble a stellar suture kit, as opposed buying a commercial version.

Ahh...the first two years of medical school. Interminable hours in the classrooms and labs. So frustrating, so eager to get in there and DO something. I'm sympathetic.

[Buckeye0311]

You don't mention what year medical student you are, but I can assure you that you will get suturing experience ad nauseum on your Surgery rotation in your third year and in any subsequent ER electives. Bear in mind that what you teach yourself now you may well have to unlearn later when your resident teaches you how to do it right, and while you're learning the practical fundamentals of wound management and wound healing.

As to "helping someone"...you mean like, suturing someone up in a car accident or something? No...you are not yet allowed to perform miracles on an unsuspecting public without supervision. Be patient. Learn the trade first. The public doesn't need your help yet.

Hmac, I am just a buck first year. A couple of my fellow first years and some second years had one of our faculty members give a lab so we could get a head start on the finer skills of suturing. Next year we have a couple 4 hour lab sessions devoted to this skill set.

I read you loud and clear about the public not needing my help yet!!;) Amen, the only thing I know how to do right now is read powerpoint slides!

[Pathfinder Ops]

Thanks for all of the replys and heads up. I am currently a medical student and just had my first suture lab, that pigs foot will thank me:D. Right now I know enough to know that I am just crawling with this knowledge, but I figured that I would get a kit so that if I was put into a worse case position I could help some one. I of course would only provide care, in this case sutures, if there were absolutely no other options. Just looking for a kit to add to my "oh shit kit" that rides in my truck every day.

YIKES on many levels.

Like:

Shelf life of the gut.
Package integrity for cleanliness.
Heat/ Cold effects on the liquids/ pharmaceuticals such as lido, which must be temp regulated between 68 & 77 deg. F etc. I'm not certain where you live but the inside of my truck (here in NY) is rarely within those parameters. And the Gut? According to the literature on the stuff we use (Maxon, Prolene and Chromatic Gut) all state that they must not be exposed to "temperature extremes."

It's possible to go on but I'm thinking those are argument enough to start.

Treat yourself well friend. Back off this; suture kit in my truck in case an "oh shit" event happens and I have no help, idea.

I'm just gonna leave this little word here: LIABILITY.

My advice (and I'm nobody);
Unless you're going way back country for long term, or OCONUS with no backup plan; just worry about stopping bleeding and closing a wound in the field using more defensible options.

Suture kits have no place as an Oh Shit bag item in modern, 1st world environments. You wanna go down range? Well there may be some instances that could justify it. Maybe.

Just because your learned a cool trick in med school doesn't mean it translates into good field craft.

Every Tactical Medic worth his salt knows that good medicine can sometimes mean bad tactics.

The above represents my opinion based on a lot of experience and training. You are welcome to ignore.

[Pathfinder Ops]

Mike G that book you mentioned looks interesting. I think I will pick it up and read it this summer when I have free time. Thanks for the info!

A med student with "free time?'

YIKES again.:suicide2:

[Hmac]

I agree that suturing in the field is a convenience, nothing more. In the civilian setting, there's no place for it. Dress it and deliver the patient to a place where they can get qualified wound management. I carry a very comprehensive suture kit for minor lacerations. I've used it maybe three times in 15 years as a convenience during training for deputies who don't want to take the time to drive to the nearest ER and wait for sutures and presuming that the wound is something simple that doesn't require debridement or extensive irrigation.

As to storage, that's no big deal. Gut can deteriorate if the individual package leaks, but nobody uses gut anymore (except for veterinarians and gynecologists). Synthetics store just fine. Their package expiration date is for the sterility of the packaging, not integrity of the material. Local anesthetics...like any drug they have an expiration date too but will tolerate the temps in a car or truck just fine if stored, say, in the trunk of something.

Medical students, depending on the school, usually get some kind of summer break between first and second years, sometimes between second and third years too.

[Pathfinder Ops]

NO ARGUMENT HERE. Just some further thought's about the OP and some of the points made.

Hmac's observations are all correct, of course. Although I'm pretty sure that frozen Lido isn't a good thing, but that's possibly a semantic.

Packaging integrity and expiration dates are agreeably absurd and part of the basic understanding in our industry. The reference to Gut was because some of us (right or wrong) do keep or are supplied "Gut" by our Vets, because of our working K9's as you pointed out with the very notable caveat of straying away from (far away from) gynecological suturing.... wink.

For most non hospital based, non physician providers; suturing is primarily a minuscule part of the greater package (mixed bag of tricks) under the extended operations scope of practice called for under VERY specific instances, and for the very example you gave of being there for other operators in our tactical microcosm.

The fact that you have only done it 3 times in 15 years is testimony to the very point I offer about suturing. It is an obscure skill set out of hospital/ medical facility and rarely a real option, let alone a priority. Indeed I've been doing the Tactical medic gig for 10 years and never sutured outside of a training environment.

Hell before I tackled getting myself a suture kit, I would go for a cool guy cricothyrotomy set up.

So my thoughts on this when I read the OP, were sort of like this:

Having a suture kit in your truck bag without the mandate of mission or appropriate circumstance, or as also pointed out sufficient training/ practice is, gear queer, fluff and possibly a liability. In fact depending on your state, it's probably illegal until "licensed" or "certified."

NONE of which includes an "oh shit" scenario outside the operating parameters of the tactical setting.

I was trying to (in an indirect way) point out some reasoning for dulling the OP's enthusiasm for suturing in the field or preparing to when there is (for him as far as I can tell) no justification nor qualification.

Consequently there is only liability left.

I have enjoyed this conversation and hope that everything I have said is taken for what it was intended:

Just my opinion and something to think about (before doing something) and by no stretch of the imagination gospel.

Good luck with med school and stay enthusiastic (Marine? 0311). You have a long road ahead

[FL2011]

A med student with "free time?'

YIKES again.:suicide2:

Haha, we have lives as well! :)

To the OP: I'm a 4th year about to graduate in 2 months and you will get plenty of experience during your clinical years. Also, a lot of times the school or a student organization on campus will hold a suture clinic at some point during the first couple years. I remember going to an Emergency Conference where they had a suture clinic for students and residents that used pigs feet

If you go here, http://www.ethiconliterature.com/ethicon/ethicon-knot-tying-kit-request-form.aspx you can request a free Ethicon knot tying kit that a LOT of docs have used at one point or another. At the least it's something you should use before your surgery rotation so you don't get that deer in the headlights look when the surgeon hands you some suture and says, "Here, tie this." :eek:

This is another "how-to suture" kit I recently came across. Seems like it's pretty comprehensive in instruction on wound care and technique as well as coming with some basic tools.
http://www.stitchupwounds.com/
It's discussed a little here if you're interested: http://forums.studentdoctor.net/showthread.php?t=801263&highlight=suturing+set

Over the past couple years in clinics and hospitals I've collected the basics and it's actually come in handy..... to suture a couple holes/rips in my white coat and a pair of pants. :laugh:

[Hmac]

The reference to Gut was because some of us (right or wrong) do keep or are supplied "Gut" by our Vets, because of our working K9's as you pointed out with the very notable caveat of straying away from (far away from) gynecological suturing.... wink.

Yeh. Didn't mean to compare a veterinarian's surgical skills to those of a gynecologist. Not out loud, anyway.





The fact that you have only done it 3 times in 15 years is testimony to the very point I offer about suturing. It is an obscure skill set out of hospital/ medical facility and rarely a real option, let alone a priority. Indeed I've been doing the Tactical medic gig for 10 years and never sutured outside of a training environment.

Well, those three times aren't counting sewing up my dog, or friends demonstrating their new Benchmade, or my kid slicing a roast, stuff like that. That was just helping out my deputy buddies and providing them with a good story to tell. The concept of our teams, my agreement with the Sheriff and County Attorney, and Good Samaritan laws mitigate any liability concerns.

But I agree....there's no such thing as "emergency wound closure" in the civilian world.




Hell before I tackled getting myself a suture kit, I would go for a cool guy cricothyrotomy set up.

I agree with that completely.

[Buckeye0311]

A med student with "free time?'

YIKES again.:suicide2:

Sometimes I even get to go back to Ohio and see my wife and I even find time to work out 4 days a week!! Yikes!!!!

Seriously, this thread is why I love this forum, bring up a topic and you will get honest oppinions and tons of info. Most of it helpful. Pathfinder Ops your take on this is very helpful and insightful. What I will take from it is this, at this point I have no business worring about this and the chance of having to employ said kit out side of my hospital is slim to none. I do feel that in the future once I have the skill set (and licensure) why not carry some suture materials in my first aid kit? What can it hurt? Better to be prepared than SOL... I appreciate that all of the items that would be in a suture kit have expiration dates, but all that means is that you have to keep an eye on your gear and replace it when needed. Nothing new about that right? Semper Fi and God Bless.

[Buckeye0311]

Haha, we have lives as well! :)

To the OP: I'm a 4th year about to graduate in 2 months and you will get plenty of experience during your clinical years. Also, a lot of times the school or a student organization on campus will hold a suture clinic at some point during the first couple years. I remember going to an Emergency Conference where they had a suture clinic for students and residents that used pigs feet

If you go here, http://www.ethiconliterature.com/ethicon/ethicon-knot-tying-kit-request-form.aspx you can request a free Ethicon knot tying kit that a LOT of docs have used at one point or another. At the least it's something you should use before your surgery rotation so you don't get that deer in the headlights look when the surgeon hands you some suture and says, "Here, tie this." :eek:

This is another "how-to suture" kit I recently came across. Seems like it's pretty comprehensive in instruction on wound care and technique as well as coming with some basic tools.
http://www.stitchupwounds.com/
It's discussed a little here if you're interested: http://forums.studentdoctor.net/showthread.php?t=801263&highlight=suturing+set

Over the past couple years in clinics and hospitals I've collected the basics and it's actually come in handy..... to suture a couple holes/rips in my white coat and a pair of pants. :laugh:

Thanks for the links. I worked with one of those knot tying kits last week. I found it pretty helpful. Good luck in your residency!

[Pathfinder Ops]

Sometimes I even get to go back to Ohio and see my wife and I even find time to work out 4 days a week!! Yikes!!!!

Seriously, this thread is why I love this forum, bring up a topic and you will get honest oppinions and tons of info. Most of it helpful. Pathfinder Ops your take on this is very helpful and insightful. What I will take from it is this, at this point I have no business worring about this and the chance of having to employ said kit out side of my hospital is slim to none. I do feel that in the future once I have the skill set (and licensure) why not carry some suture materials in my first aid kit? What can it hurt? Better to be prepared than SOL... I appreciate that all of the items that would be in a suture kit have expiration dates, but all that means is that you have to keep an eye on your gear and replace it when needed. Nothing new about that right? Semper Fi and God Bless.

I agree with all of the above. It's refreshing to engage on an honest level with folks like yourself, Hmac and the others around here. So many people tale offense so this was a good thread from the level back and forth.

Good luck and stay the course.

Pathfinder out.

[redhands]

Oh boy, a post that I have experience with. My father and grandfather were both veterinarians and I am a practicing OBGYN.
Yes, both use chromic suture because it is inflammatory and it rapidly dissolves. dentists and oral surgeons use it too. I have heard it is being phased out by the newer absorbables like vicryl rapide.
It has its uses but I avoid it.

I would not suture any wound "in the field."

Really bad bleeding can be stopped with a tourniquet or pressure.

It is possible to bleed out from a scalp laceration eg William Holden.

My dad never tied with his hands(instrument ties) because suture costs money. And I could not tie until the first day of residency.

[motorwerks]

Saw this today and I thought of this thread. I totally get what the OP is talking about. In an end of the word as we know it situation...... better safe then sorry. I almost bought one of these....

http://www.adventuremedicalkits.com/product.php?product=198&catname=Travel&prodname=Suture/Syringe%20Medic

[motorwerks]

I dug a little deeper and found this too.

http://www.shopatron.com/products/productdetail/part_number=0155-0316/453.0.1.1