# Sutures and Other Stuff



## GTGallop (Nov 11, 2012)

I found out there is a pretty robust medical supply business located close to the house. I've been looking to fill in some of the more advanced medical items in my kit. One thing I know I need is a suture kit. But as I started to look there were several different types. I'm not trained and not going to use it until I am (have a medic buddy that will show me in a few months when he comes to visit), but would like to get a few kits to practice with and to have in my bag in the event that I'm with someone who knows how to use them.

Also, what other stuff should I consider? Stuff you can't get at CVS, Walgreens, Osco, Walmart, Target, etc?

Right now my bag is mostly AB pads, maxi pads, gauze, tweezers, snake bite kits, gloves, various cleansers, and some sterile water (that is probably bad by now). I have a stethoscope and will be getting an O2 monitor. I also keep a sharpie in my bag so I can write a log on the patient of when the injury occurred and what I did. That way if they get airlifted w/o me the real medical professionals will know what has been done.


----------



## bigwheel (Sep 22, 2014)

All a person needs for sutures is cat gut. We have two cats who might be willing to donate. Now in the movie Old Yeller mama sewed up the kid with hair from a mule's tail...mule named Old Jumper. That might just work too.


----------



## Quip (Nov 8, 2012)

I found a kit on Amazon that had sutures, scalpels, scissors, hemos and a few other items. Came in a nice little roll up canvas pouch. I vacuum sealed it and dropped it into my main bag. You can also get vet/animal sutures to practice with. I've even seen pig type hides for practice


----------



## Prepadoodle (May 28, 2013)

I carry a suture kit with a variety of sutures. Sewing myself up probably isn't gonna happen. Sewing on someone else probably won't happen either. I also carry superglue for skin tears. Deeper wounds involving muscles or arteries or whatever is more than I am capable of dealing with. Learning how to physically do it is pretty easy, knowing when and where is another matter. So why carry them if I don't think I will ever use them?

The minor reason is that I'll have them in case someone who knows what they are doing is around. Slim chance of that, but eh.

The main reason I carry them is that they are great for fixing gear. The curved needles and strong nylon or silk threads are handy and can repair a pack, strap, or boot. They weigh next to nothing, so well worth having.

As far as other items...

A tourniquet is a must have, in my opinion. So is an airway adjunct. (I carry several sizes of nasopharyngeal airways). I also carry 2 Asherman chest seals for sucking chest wounds. These have a built-in valve which can prevent tension pneumothorax and are easier to use for poorly trained individuals like myself. Most bleeding can be stopped with gauze packing and direct pressure, so I have a few Israeli bandages 4" and 6", with and without the secondary pad. I also carry a Quickclot Z-fold combat gauze and a couple of Quickclot Sport Sponges. A good pair of EMT shears is also a must.

This particular kit also contains a variety of other items: Sharpie, pen, flashlight, notebook, various gauze pads, rolled gauze, sticky stretch bandages, burn gel, triangular sling thingies, duct tape, eye wash and pads, a Sam splint, tweezers, a mylar space blanket, and a bunch of other little stuff.

This kit goes in the car with me whenever I go in the car. It also goes from my car to the firing line at the range. It's designed for first aid. To me, this means make sure they are breathing, stop the bleeding, treat for shock, and try to hang on until medical professionals arrive.


----------



## RNprepper (Apr 5, 2014)

Steristrips can work just fine for skin lacerations, especially if they are not over a joint. That's where sutures will hold better. I got all my sutures at https://www.esutures.com/
The most important instrument is a GOOD needle holder, as well as quality skin forceps. Suturing has to be done, ideally within 12 hours. The wound needs to be CLEAN. If not, you are just sewing in an abscess. A skin stapler is also really handy - especially for scalp lacerations. But you have to have the staple remover, as well.

Go with steristips when you can.

And remember that many wounds will heal on their own, as open wounds that heal from the inside and outside edges as they close in. An old laceration (more than 24 hours) HAS to heal this way. Sure, it leaves a bigger scar, but it _will _heal if you can keep infection at bay.


----------



## GTGallop (Nov 11, 2012)

RNprepper said:


> An old laceration (more than 24 hours) HAS to heal this way. Sure, it leaves a bigger scar, but it _will _heal if you can keep infection at bay.


Chicks dig body damage. ;-)


----------



## Farmboyc (May 9, 2015)

bigwheel said:


> All a person needs for sutures is cat gut. We have two cats who might be willing to donate. Now in the movie Old Yeller mama sewed up the kid with hair from a mule's tail...mule named Old Jumper. That might just work too.


My dad did it once with a horse. Cut got infected snd the damn stitching broke in 3 or 4 days. Big damn mess. Better off using thread from the sewing box.


----------



## Auntie (Oct 4, 2014)

Someone on here recommended I practice stitching on chickens.Sorry I am to tired to search the posts to give credit where credit is due. Of course dead chickens should be used, because their skin is similar to humans. I have been trying it and getting better at it, I no longer pull the stitches through the skin. My nephews were kind of nervous when they saw a wing sewn to a thigh HAHAHA. I tried to tell you I am the crazy Auntie. I started by making a cut in the chicken skin and then sewing it together. I usually use the back of the chicken to practice. I still can't do the fancy stitches that doctors use. My theory is if someone is asking me to stitch them up it is because there is no doctor available. 

A neighbor told me when he was in the rodeo they would use a hair from a horse tail for stitches. I don't know that I am brave enough to put myself at the back of a horse and try to pull out a part of his tail. Did I mention I am terrified of horses?


----------



## Kauboy (May 12, 2014)

RNprepper said:


> Steristrips can work just fine for skin lacerations, especially if they are not over a joint. That's where sutures will hold better. I got all my sutures at https://www.esutures.com/
> The most important instrument is a GOOD needle holder, as well as quality skin forceps. Suturing has to be done, ideally within 12 hours. The wound needs to be CLEAN. If not, you are just sewing in an abscess. A skin stapler is also really handy - especially for scalp lacerations. But you have to have the staple remover, as well.
> 
> Go with steristips when you can.
> ...


The steristrips are a great recommendation!
I'll be looking for some to add to my pack next.

For open wounds that are passed time, I've read that packing them with honey can keep bacteria at bay. Does this affect the healing process at all, or safe?


----------



## Medic33 (Mar 29, 2015)

2.0 standard sutures 
you need some locking small forceps the kind that a lot of pot heads used for their roaches they are the same same. 
advise on sutures - you might need something to deaden the area cause it really sucks when the PT jerks away in the middle of it or a means of restraining the area you want to work on like tying it down to an arm char or something..
as for practice:
use a chicken you got from the grocery store just a leg or quarter will do make sure the skin is on it and make small slices with a knife to sew up.
or
you can use the rubber underarm pad from some crutches I used both in med school.


----------



## GTGallop (Nov 11, 2012)

Thank you *ALL *- great suggestions in here.


----------



## Medic33 (Mar 29, 2015)

GTGallop said:


> Chicks dig body damage. ;-)


not really -I have enough for both of us. LOL sometimes it isn't so cool when people stare at you with horrified shocking looks you know the WTF happened to you kind of thing.


----------



## RNprepper (Apr 5, 2014)

Sewing on raw chickens is not actually recommended now because of the salmonella factor. Honey can be used in a wound, especially a draining one. There is actually a thick pasty salve called "Med Honey" that is used by wound care specialists on draining wounds. The sugar creates an osmotic "vacuum" that helps draw out drainage. Alternative suture material has been used forever - like a hair from horse tail, or even the threads from the agave - cut off the sharp needle and pull out the long strands that are still attached to the ready made needle. BUT..... for any of these, you better sterilize it good before using or else you are going to drag loads of bacteria right through the wound with every stitch. This is also true if you use sterile suture and part of it falls off your sterile field and hits your pants or the patient's arm or anything that is not clean - loads of bacteria delivered right to the site.  It takes more than wiping it with an alcohol pad. Cold sterilization chemicals take between 20 -40 minutes to achieve sterilization.

Your best bet is still to use steristrips whenever you can.

About superglue. It can work on superficial lacerations, and is really good for those nasty painful cracks you get at the corner of your nails when it is dry. BUT.... the glue does NOT go into the wound. The skin has to be held together and then the glue is applied over the top of the wound - not in it. Hold it until it dries. Then add 2 more layers. All it is doing is holding the fresh edges together against each other so they can heal. The edges are not glued together. Dermabond is the medical equivalent and it is basically sterile super glue. With regular glue you still have to consider that it is not sterile and could potentially introduce bacteria. But if it was a fresh tube, it might be practical.


----------



## Medic33 (Mar 29, 2015)

well about the chicken all I can say is get used to wearing latex exam gloves. 
suturing is considered a minor surgery and with a sterile field you should be wearing sterile gloves that are similar but not exam type gloves.
but putting them on is a lesson on it's own as well as taking them off.


----------



## Medic33 (Mar 29, 2015)

also if your going to use other material for suturing sterilize it all by soaking it in iodine/betadine for at least 30- seconds or longer if you can.


----------



## Prepadoodle (May 28, 2013)

Several products can help numb an area if you really want to sew someone up. Look for stuff containing either benzocaine or Lidocaine.

Benzocaine products are usually sold as oral gel for toothaches. I've never used it on skin, but it should work, I think. The one made by Dr. Sheffield advertises that it's 20% benzocaine, which is a little hard to believe, but I have used it on toofs and it does work. Dr. Sheffield's Oral Pain Relief

As far as I know, the strongest lidocaine you can get over the counter is 5%. They use this to deaden the pain of waxing or when yer gonna get a new tat. I have some, but have never tried it. It's in my big first aide kit, and I don't remember the brand name. This one would probably work as good as any... TOPICAINE

Maybe one of the medical types will chime in and tell us a little about the effectiveness and dangers of these kinds of products. I would be interested in hearing what they have to say about them.


----------



## MaterielGeneral (Jan 27, 2015)

Check out this Americaine Benzocaine Topical Anesthetic Spray Itch Relief 2 oz Pack of 3 | eBay 20% Benzocaine.

I keep this spray in my first aid kit. It works pretty good at stopping/preventing pain. It works on itch also.


----------



## Medic33 (Mar 29, 2015)

Prepadoodle said:


> Several products can help numb an area if you really want to sew someone up. Look for stuff containing either benzocaine or Lidocaine.
> 
> Benzocaine products are usually sold as oral gel for toothaches. I've never used it on skin, but it should work, I think. The one made by Dr. Sheffield advertises that it's 20% benzocaine, which is a little hard to believe, but I have used it on toofs and it does work. Dr. Sheffield's Oral Pain Relief
> 
> ...


most of those topical stuff doesn't work -think you are stabbing a needle into a wound -Marcaine dude and a syringe inject it -or a 5th of jack danels and a couple ropes to tie the area and person down so they don't punch you in a drunken rage.


----------



## 1skrewsloose (Jun 3, 2013)

THIS is one very informative and practical thread!! I know zip about medical besides putting on a bandaid. Thanks a big one! Will do some more research on this. Great Thread!!! jmo.


----------



## darsk20 (Jun 1, 2015)

1skrewsloose said:


> THIS is one very informative and practical thread!! I know zip about medical besides putting on a bandaid. Thanks a big one! Will do some more research on this. Great Thread!!! jmo.


Ditto. Added steristrips to the Amazon wish list.


----------



## Lady_Husker (Aug 8, 2015)

From what my dad told me about his experience as an army medic, dental floss makes for a good suture material. Find the right kind, and it will even dissolve on its own (after time) so there will not be a need to remove the sutures. Have never tested this, but it seems legit.


----------



## paraquack (Mar 1, 2013)

Maybe back in the day, but I don't think floss self destructs like it did back when I was kid.


----------



## Lady_Husker (Aug 8, 2015)

Eh, either way, in a pinch it might just work. Someone should test it!


----------



## paraquack (Mar 1, 2013)

Regular sewing thread works, ask my sister. After she sobered up, early the next morning, she went to doctor and he basically said, it would have been better if you sterilized it first, but no sense taking it out now.


----------



## Medic33 (Mar 29, 2015)

yes I think dental floss would work ok.
another thing about sutures leave them in for 14 days the book says 7-14 but I say 14 minimum.


----------



## tirednurse (Oct 2, 2013)

Medic33 said:


> yes I think dental floss would work ok.
> another thing about sutures leave them in for 14 days the book says 7-14 but I say 14 minimum.


that would really depend on how fast the wound heals. I have seen many wounds heal in 7 days. the norm is for a clean wound to close within 10 days. the longer the sutures are left in the harder they are to remove cleanly. sometime the ones left in too long need to be dug out of the skin. left in they will create their own problem.

as for the item used as sutures.... I have used fishing line or strong thread many times on my animals with good results. the most important thing to remember is that the wound needs to be totally clean as well as sterilizing the items you choose to use. 
I stitched up a herniated bowel in a pig one time when it was about 4 weeks old. I left them in for 6 months until he was butchered. he never had a problem and all I used was fishing line and lots of flushing the entry site with lots of betadine.


----------



## Prepadoodle (May 28, 2013)

Real men bite the bullet out of a round, dump the gunpowder on the wound, then put fire to it.


----------



## RNprepper (Apr 5, 2014)

Medic33 said:


> yes I think dental floss would work ok.
> another thing about sutures leave them in for 14 days the book says 7-14 but I say 14 minimum.


PLEASE don't do that on a facial wound. 5 days and most of those are ready to come out, or else there is going to be a really nice scar. Embedded sutures are really nasty to remove. Ditto everything TiredNurse said.


----------



## 1skrewsloose (Jun 3, 2013)

Prepadoodle said:


> Real men bite the bullet out of a round, dump the gunpowder on the wound, then put fire to it.


 You've been watching too many old Clint Eastwood movies!! two mules for sister sarah.


----------



## paraquack (Mar 1, 2013)

Prepadoodle said:


> Real men bite the bullet out of a round, dump the gunpowder on the wound, then put fire to it.


You're talking about me dumping the powder on your wound and then lighting it, right?


----------



## Prepadoodle (May 28, 2013)

paraquack said:


> You're talking about me dumping the powder on your wound and then lighting it, right?


No no no, I was thinking that you do it to yourself. I'll use steri-strips.


----------



## paraquack (Mar 1, 2013)

Not enough booze for that.


----------



## Medic33 (Mar 29, 2015)

gunpowder on a wound dude I think you watched rambo to many times if you did that it would kill you.
and for sutures I really don't think you going to mind a scar in an EOTWAWKT situation I think you'll be really happy it is healed.


----------



## tirednurse (Oct 2, 2013)

Medic33 said:


> gunpowder on a wound dude I think you watched rambo to many times if you did that it would kill you.
> and for sutures I really don't think you going to mind a scar in an EOTWAWKT situation I think you'll be really happy it is healed.


nobody would be happy having each one of those sutures cut out and having to heal the wound again. why open the skin again and risk infection again when it could have been healed?


----------



## A Watchman (Sep 14, 2015)

Thanks all. This was a great read for me as med stuff is not my field of expertise, but I have some new ideas to pursue. Hospitals make me queasy. Guess I better keep my wife around, she works at a local hospital in the OR as a surgical technician..


----------



## Medic33 (Mar 29, 2015)

tirednurse said:


> nobody would be happy having each one of those sutures cut out and having to heal the wound again. why open the skin again and risk infection again when it could have been healed?


well in the field you not in a exactly sterile environment so if you can't remember when to take out the sutures and check the wounds daily then you have no business providing medical attention to anyone including yourself.


----------



## tirednurse (Oct 2, 2013)

Medic33 said:


> well in the field you not in a exactly sterile environment so if you can't remember when to take out the sutures and check the wounds daily then you have no business providing medical attention to anyone including yourself.


Medic I hope that you are not trying to imply that I don't know what I'm doing. I deal with wounds day in and day out. I heal the wounds the doctors can't. I heal both nice clean surgical wounds as well as those gone bad. I heal dirty trauma wounds of all kinds. You are the one reading from a book and telling people your misguided opinion. Have you ever even removed a stuture or surgical staples? No? then don't give out advise on something you no nothing about.

thanks!

RN, BSN, WOC and will soon start courses to become a CNM. I do not work in a nice sterile hospital. I work in some of the worst conditions you can imagine. I go where my patients are. what do you to? drive around looking for twinkies?


----------



## paraquack (Mar 1, 2013)

Medic33 has said a few things that have ruffled the feathers of myself and at least one other medical professional. If I remember correctly, he said he was a medic in service. I've seen a couple of the military medics go thru the paramedic class in the area I served and they had a very high opinion of themselves. I think it might be something the military instills so they think they are God's gift to the wounded, so they will do what needs to be done. Unfortunately that attitude carries over. While I would not want to perform as a paramedic under fire, I also have had to work in some of the most dangerous, dirtiest scenes you can imagine. And I didn't work in Chicago. The stories my buddies fro Chicago told me rival anything I've heard from battlefield adventures.
Obviously if he trips your trigger too much, there is always the IB (ignore button). I personally try to reserve that for the those who trip my trigger repeatedly. Besides, he has had more than one good idea in the 6 months he's been here, can't remember it, but I'm pretty sure.


----------



## barterdoc (Sep 20, 2015)

Something to consider when it comes to sutures. I always tell my patients, when stitches (sutures) are an option...
ANY wound can heal. No matter how big or deep. If you keep it clean your body can heal it. There are advantages to stitches. 
1)Smaller scar. Stitches usually make the final result look more cosmetically pleasing. 
2)Less bleeding. Stitching a wound brings the edges together so you don't have to deal with the bleeding as much. A wound left open will be more likely to bleed off and on, but it can be dealt with.
3)Less infection. A closed wound will be generally more protected from infection.
BUT, and this is super important, some wounds are actually less risky for infection if you DON'T stitch them up. Animal and people bites are the most common examples. Keeping it open and cleaning it thoroughly a couple times a day helps clean out the bacteria left behind from the mouth of the animal or person. Sewing it close can actually seal the bacteria in and INCREASE the risk of infection. 
Also, super dirty wounds may be better off being kept clean and not stitched. Leaving them open to heal naturally, "by secondary intention" as we put it in the medical world, allows you to keep cleaning it out as it slowly heals.


----------



## Denton (Sep 18, 2012)

tirednurse said:


> Medic I hope that you are not trying to imply that I don't know what I'm doing. I deal with wounds day in and day out. I heal the wounds the doctors can't. I heal both nice clean surgical wounds as well as those gone bad. I heal dirty trauma wounds of all kinds. You are the one reading from a book and telling people your misguided opinion. Have you ever even removed a stuture or surgical staples? No? then don't give out advise on something you no nothing about.
> 
> thanks!
> 
> RN, BSN, WOC and will soon start courses to become a CNM. I do not work in a nice sterile hospital. I work in some of the worst conditions you can imagine. I go where my patients are. what do you to? drive around looking for twinkies?


I used to go along with my first wife when she did home health jobs. She didn't feel safe at some places so she took her gun-toter.
I felt more endangered by the lack of cleanliness, and felt the need to get more vaccinations!


----------



## paraquack (Mar 1, 2013)

I for one do not wish anyone having to have a wound heal by second intention. From my own personal experience, it is a real pain in the a$$. It took in the neighborhood of 4-5 months for an incised abscess to properly heal. Taking care of it was no picnic. But sometimes you have to bite the bullet and trust in your body. It's a wondrous what the body can do for itself.


----------



## Dirt Road Cowboy (Nov 22, 2015)

I learned how to properly suture a wound when I was an 18 y.o. EMT back in 1980. I didn't have anything more important to do than hang around the ER, and I wanted to learn as much as possible (I had planned to become a doctor, but I couldn't get the finances for school).
The doctors and nurses put up with me and showed me a lot.

Anyway, the only person that I ever stitched up was me. Both times left handed (and I'm a righty)! The second cut was a knife cut on my right forearm that took 10 stitches to close. I showed it to an old army doctor and he told me that I did a really good job, but if I ever did it to someone else I'd get my but sued off! (It was above and beyond my qualifications and license.)

He showed my a technique that would be legal to use on others, and would be much less painful:

Take 2 strips of medical adhesive tape just a little longer than the wound that needs sutured (the white stuff that will pull the hairs off your arms when you remove it). The 1" stuff works best for this, but you can use the narrower kind if that's all you have. 

Then fold one fourth to one third of the strip over lengthwise (sticky to sticky).

Irrigate the wound to wash away any contaminants, and dry the skin around the wounded area.

Place the tape strips just outside of the wound (with the folded edges toward the inside of the wound). Not too close or too far apart.

Then, sew the folded tape strips together instead of the skin. The tension on the tape will pull the edges of the wound together just like the sutures will, and there is no need to puncture the skin. This works well with non sterile equipment (you can use a regular sewing needle and thread) since the needle and threads do not actually contact the skin. (Just keep everything as clean as you possibly can anyway.)

Then cover the sutured area as you normally would. (Antibiotics and sterile dressing.)

This is also good for children and people that are squeamish around needles.

I hope this will be able to help someone out.

(Some of you pros probably know all about this, but I'm new here and just trying to contribute.)


----------



## freekitten (Feb 22, 2016)

Dude, why don't you just buy a disposable surgical stapler and call it a day? Learning to suture is a skill.


----------



## SittingElf (Feb 9, 2016)

freekitten said:


> Dude, why don't you just buy a disposable surgical stapler and call it a day? Learning to suture is a skill.


...or for a lot cheaper.....Steri-Strips or Medical Super Glue.


----------

