Sutures what's a good all around type?

[jakeb]

Hey All,

I'm putting together a kit for when we go camping and wanted to put in a few suture kits.

What's an all around good type and size to work with? For general lacerations?

Also what's a good type/size for finer work? Like smaller cuts or places that would scar easier?

Thanks,

Jake

[Derek_Connor]

Hey All,

I'm putting together a kit for when we go camping and wanted to put in a few suture kits.

What's an all around good type and size to work with? For general lacerations?

Also what's a good type/size for finer work? Like smaller cuts or places that would scar easier?

Thanks,

Jake

Jake,

Do you know how to suture?

"general lacerations" is just that, pretty general.

Are talking about lacerations down through the sub-derm, fascia, and into deep muscle?

What is your plan for blood loss prevention?

Do you have decent needle drivers? Jewelers would work as well.

Assuming a deep laceration into the muscle, I would like a anti-microbial lined 0 Vicryl for muscle, 2-0 Vicryl for fascia and above and some type of 4-0 nylon for skin. These will eventually absorb into the body, so its up in the air if you will be suturing something for good or temporarily? If temp, obviously get something non-absorbable.

Thinking outside the box though, if you get cut w/something that bad out there in the field/woods, blood loss and thrombosis will be priority.

Suturing up the wound could be done, but keep in mind that whenever the primary responders are treating the victim that they are going to cut those sutures and clean out that spot anyways.

If you need practice for suturing up a wound, get some old jeans, douse them in ketchup, and practice closing the wound like that. And if its too wet/sticky, use something equivalent to 4x4s to aide you in cleaning up the wound..

Im no MD or ER doc, but depending on it, I think stuffing the wound after cleaning it the best you could, and dropping staples on it might be an easier way until qualified people get out there..

[Jim from Houston]

Try one of these...a lot easier to use (especially on yourself) during a medical emergency.

http://www.chinookmed.com/cgi-bin/ca...source=froogle

Quite frankly, suturing human flesh is really, really hard. If you don't seriously know what you're doing, it can turn into a big ol' mess real quick (a buddy of mine once tried to give himself stiches on a slashed finger while camping...it did not go well)

The stapler is way more straightforward for the non-doctor peanut gallery, such as myself.

That being said, if I were alone in the forest, gushing blood from a wound, I would definitely hope to have Celox or Quick-Clot on hand rather than any of the above...

http://www.chinookmed.com/cgi-bin/ca.../s-hemostatics

[dhrith]

Damn, that looks slick, and cheap too.

[citizensoldier16]

Most products like the stapler listed above require either an MD's license or a prescription to purchase. Many medical products, including such mundane things like oxygen nasal cannulas are RX only.

For minor lacerations, a bent sewing needle and dental floss would work well. For more serious bleeding, you're better off using a hemostatic like QuicClot or the like.

[FMF_Doc]

Ethicon 3.0 Gut or Chromic Gut is a good all around suture and suitable for everything except faces pretty much. While I prefer to use Lidocaine before suturing, I wouldn't hesitate to sew without it if needed.

There are several good technique books out there on wound closure that would provide more in depth information.

Although after I learned to use the staples, I rarely sutured unless it was on the face or hands.

Kwik Clot and Celox type products are great for controlling immediate bleeding but really do nothing to permanently correct the injury.

[RESQDOC]

Knowing when & how to close wounds is important; knowing when not to close them is critical. Most 'wilderness' wounds are filthy and require significant cleaning and possibly delayed closure or alternate techniques. Closing a dirty wound is the highway to sepsis.

That being said, staplers are very handy in the pack. For suture we suggest 4-0 Vicryl or Chromic Gut on a C-2 needle, or 3-0 on a FS -2 or FS-3 needle. These are absorbable sutures allowing them to be used inside a wound, as well as on the skin. They can be left in place and not removed later if need be, although this is not preferred. These are strong enough to close essentially any skin with proper technique, yet small enough to not scar too badly on more delicate skin.

There are countless variations and improvisations as well.

[Spike59]

Use should always carry Super Glue as a liquid suture solution. If it is a laceration that is not life-threatening but needs to be closed you should think about Super Glue. It is non-toxic and bonds instantly. Be sure to clean the area as best you can before you apply. I have used it on myself and my sons in the past. It is used in the ER to minimize scarring.

[NinjaMedic]

Primary wound closure can lead to life and limb threatening situations. Take a sewing kit, you know for your tent or blue jeans. If you havent been trained to the level to choose the appropriate suture then you sure as hell dont know enought to 1) properly close a wound and 2) know when not to close the wound . . .

[Hmac]

Superglue and staplers. The only reason to use suture would be if you want it to be pretty, but the only way that's going to happen is if you find a LOT more training. Staple closure makes for a noticeably worse looking scar, especially for someone inexperienced in their use, but if we're talking about a traumatic wound that you just dumped a bunch of Celox into, cosmetics has pretty much gone out the window anyway.

You can get skin staplers for $20 from most veterinary supply places. Buy a few, then go get some pig's feet and practice.

Eta: good point about knowing when NOT to close a wound.