Want Sutures? Bad Idea! (Wound Healing Without Sutures)

[Hmac]

Apparent to me is a lack of clarity on why one would forgo usual medical protocols.. This discussion is clearly not intended for the present state of available medical care, nor the litigious environment of current US "medicine".

If in an austere environment, rapid definitive lasting treatment is needed. Facing extremely limited resources, minimal time with a medically trained person & likely won't have a chance to do a "follow up" in any method understood in a 1st world benign setting.. if at all.

Additionally, minimizing ones activities post tx is seldom an option in this. Clean, debride, prophylaxis(if available), seal wound, kick out the door.

SUTURES ARE GOOD.

if you don't understand anatomy deep layered sutures to the surface close may be a stretch. But it's certainly not rocket science. The body is amazingly resilient if you give it a chance.

I've trained and used illiterate medics to good effect. A literate educated person with the right guidance / books can do fine.


Based on couple decades+ of 3rd world experiences, in proximity to loud noises, with minimal resources.

The reason as to how a given wound is managed depends on a variety of factors, including what caused the wound, under what circumstances, extent of tissue destruction, skill and/or knowledge of the person attending the wound, availability of resources during the management and afterward. No one-size-fits-all. Circumstances dictate the approach. The best one can hope for is someone attending the wound that understands the basic principles of evaluation and management.

Sutures are good in most circumstances for simple wounds. Sometimes they're not and the wound should be packed open. Those are "usual medical protocols" in the ER, the OR, or the zombie apocalypse, and even in an attack by a hoard of malpractice attorneys.


/

[JB2000]

What about using maggots in a SHTF situation to debride a wound? Assuming you could get disease free larvae, would there be any advantages to cutting away tissue or just letting it heal on it's own? Is it necessary to debride wounds if there it's dead tissue present?

Thanks.

[Hmac]

Yes, it's necessary to debride a wound of dead tissue.

Yes, maggots will do an excellent job of debriding a wound.

No, they won't necessarily do a better job than someone who has the proper tools and knows what they're doing.

[JB2000]

Thanks HMAC and the others providing their expertise here. This is excellent information I think you would be hard pressed to find elsewhere.

[chadbag]

Literature on use of Honey as anti-bacterial

---

A specific honey called Medihoney

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2686636/


---

Natural honey antimicrobial effects

http://www.ncbi.nlm.nih.gov/pubmed/15298770

---

There are a lot more out there for specific ailments etc.

Honey is not homeopathic BS. (It is not even homeopathic, so saying it is just shows ignorance).


-

[Hmac]

Literature on use of Honey as anti-bacterial

---

A specific honey called Medihoney

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2686636/


---

Natural honey antimicrobial effects

http://www.ncbi.nlm.nih.gov/pubmed/15298770

---

There are a lot more out there for specific ailments etc.

Honey is not homeopathic BS. (It is not even homeopathic, so saying it is just shows ignorance).


-

I don't mean to question your credentials as a medical professional. I know that Google has, in large part, replaced the need for doctors.

But yes...homeopathic bullshit. I'll be happy to refute further if you care to relate your experience with its use in a clinical setting, or if you could provide some evidence of your ability to parse the value or relevance of medical literature in the totality of literature available. Failing that, I'm not really inclined to argue about what you think you know about the practice of medicine.

[chadbag]

I don't mean to question your credentials as a medical professional. I know that Google has, in large part, replaced the need for doctors.

But yes...homeopathic bullshit. I'll be happy to refute further if you care to relate your experience with its use in a clinical setting, or if you could provide some evidence of your ability to parse the value or relevance of medical literature in the totality of literature available. Failing that, I'm not really inclined to argue about what you think you know about the practice of medicine.

Well, you are just as ignorant as I am then, as it is not HOMEOPATHIC BS. Honey is not HOMEOPATHIC, therefore it cannot be HOMEOPATHIC BS. You may make the claim that the use of Honey as an anti-microbial in wound management is BS. You are welcome to your opinion. But you called Honey Homeopathic which is factually incorrect. (Btw, I don't practice homeopathy either and am not defending it here.)

I pointed out papers on the NIH website that dispute that and they include instances of Honey being used in a clinical setting (MediHoney -- Honey produced under exacting controls and setting and licensed for clinical use). But I'll defer to your all knowing presence and ignore the medical literature.

And for the record, I never claimed to be a medical professional nor did I claim Google made me one. Google only pointed to published papers on the NIH website, which you obviously did not even go read the extracts on, that disagree with your so-informed opinion. But I guess Google made you a homeopathic expert as well.


--

[Hmac]

Well, you are just as ignorant as I am then, as it is not HOMEOPATHIC BS. Honey is not HOMEOPATHIC, therefore it cannot be HOMEOPATHIC BS. You may make the claim that the use of Honey as an anti-microbial in wound management is BS. You are welcome to your opinion. But you called Honey Homeopathic which is factually incorrect. (Btw, I don't practice homeopathy either and am not defending it here.)

I pointed out papers on the NIH website that dispute that and they include instances of Honey being used in a clinical setting (MediHoney -- Honey produced under exacting controls and setting and licensed for clinical use). But I'll defer to your all knowing presence and ignore the medical literature.

And for the record, I never claimed to be a medical professional nor did I claim Google made me one. Google only pointed to published papers on the NIH website, which you obviously did not even go read the extracts on, that disagree with your so-informed opinion. But I guess Google made you a homeopathic expert as well.


--

I have spent a lifetime creating wounds, fixing wounds, and treating wounds that other doctors don't have the expertise to fix themselves. To be labeled as ignorant about an area of the practice of medicine that I do every single working day of my life for 30 years by a..what?.. "cell phone app developer"? That goes beyond laughable. Try to stay in your lane. A Google search and review of any literature without any clinical expertise whatsoever makes you just look pathetic.

[chadbag]

I have spent a lifetime creating wounds, fixing wounds, and treating wounds that other doctors don't have the expertise to fix themselves. To be labeled as ignorant about an area of the practice of medicine that I do every single working day of my life for 30 years by a..what?.. "cell phone app developer"? That goes beyond laughable. Try to stay in your lane. A Google search and review of any literature without any clinical expertise whatsoever makes you just look pathetic.

I did not call you ignorant in general. I said you were ignorant when it came to homeopathy, since you have repeatedly labeled honey as being "homeopathic BS" when it has nothing to do with "homeopathy." And since you have great disdain for homeopathy, I assume that your 30 years experience treating wounds has not included homeopathy, hence your statement above is superfluous. (And as I have noted, I am not a follower of homeopathy, and am somewhat of a sceptic on it).

Let's be clear:

1. I have not said that you should be using table honey or any honey clinically. (even the medihoney which is not approved in the US)

2. I pointed out that there is medical literature with regards to honey being used medically to treat certain kinds of conditions. Lots of it. There are also approved medical products based on honey in use in Australia and Germany, including in clinical settings. Your general POOH POOHing of honey as an anti microbial goes against medical literature -- note I did not look stuff up on eHow.com or Answers.com or anything -- I used abstracts of published medical literature listed on the NIH website. Hardly produced by ignoramuses. I have a science background and am capable of reading abstracts of papers and getting the general gist and a general understanding. I did not make any specific claims as to exactly what conditions and under what condition the use of honey is appropriate in anti-microbial applications. I only said that such applications exist, contrary to your exclamations (mostly in other threads, but also in this one). I would hope that you would pursue the literature as it pertains to honey used for anti-bacterial function in wound control. Some of the instances listed in its use in Germany were interesting (basically shutting down MRSA where a local antiseptic [octenidin] was ineffective). With all the concern about MRSA and the resistance it has and is continuing to develop against other medicines, honey may be an effective weapon.

Really, I would encourage you to read this and follow up with the footnotes and other references listed with it.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2686636/

This is not homeopathic BS. It is an approved medical treatment used in clinical situations for wound care.

3. You have not shown ANY sort of evidence (published in the medical literature, or even your own research) that contradicts the use of honey (including medical grade honey) for certain sorts of would treatment. You have only put on your MD hat and said that only you are capable of understanding this and everyone else is ignorant and to leave it to the experts. While I respect your knowledge and experience as an MD, and are quite capable at what you do and within the boundaries of your knowledge and experience, an expert, I would guess that you have not read every journal that exists, nor are expert in every facet of medicine, and that others doctors and scientists might know something as well. Including those that have studied the use of honey and have approved it for medical use (in Europe and Australia, who are practitioners of modern medicine) and have written published papers on the subject.

4. I have made no claims for sugar. I could find no positive mention at all in literature and in fact noticed mention that certain tested bacterias were able to survive even with 100% glucose (though table sugar is mostly sucrose). However, sugar is also not homeopathic, so while it may be BS, it is not homeopathic BS.


--

[currahee]

A) I keep a sports bottle in my larger aid kit in case I ever have to do irrigation away from running water- is that enough pressure?

B) Could you elaborate on the difference between clean and sterile water? I know that seems goofy, but what if you were in the field? Stream water filtered- that sterile enough? What about adding a few drops of betadine or bleach?

C) I imagine picking out obvious foreign material and trimming any obviously dead tissue away is a good idea (I have dissected many animals)

I never though of suturing as a serious option for the amateur... I'd rather be in a hovel for a month trying to keep a wound clean then going all Rambo with my fishing kit- so thanks for this info.