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Permalink Reply by John A. on February 21, 2013 at 9:59am

As clearly mentioned in what I said "it's great for small stuff", is exactly what was mentioned.  If your intestines are laying in your lap, I believe your problems are more pronounced than trying to decide what to suture it up with.  The OP was discussing what to use in a pinch, at least that was my take on it.  If it's a chest wound or major trauma, it makes sense that your problems, and therefore solutions are different. 

 

But please, I differ to your obvious depth of knowledge on the subject. 

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Permalink Reply by Sean O' on February 19, 2013 at 10:51pm

3-0 is a good general size. Get sutures that are already armed. 5-0 is great for face wounds, but can be difficult to work with and is too fine for about anywhere else. If you will be able to remove them when appropriate then go for nylon. If not then use chromic gut (AKA: cat gut). Gut gut will slowly be absorbed over time.

Topical anesthesia is only effective on mucus membranes unless you have the skin of a 2 year old girl (and even then it wont be much help for sutures). A skin stapler would be much faster and easier to do one handed. Tying a surgeon's knot one handed is a cool trick, but it takes an incredible amount of practice. Instrument ties are much easier, but require two hands.

There are several different suture techniques. Simple interrupted is the simplest and most durable. Running sutures can be faster, but require more skill.

Before attempting to suture/staple remember: The solution to pollution is dilution. Thoroughly clean the wound. Soap and water work just fine. Use at least 1 - 2 liters of water.

I have thrown a lot of stitches, both in hospitals and in much more austere environments.

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Permalink Reply by Liam S. on February 19, 2013 at 11:02pm

Get some of these - http://www.bestglide.com/Emergency_Bandage.html

And for smaller things, tincture of benzoin (don't use near eyes) and butterfly strips. The benzoin around the wound will make the strips stick better. 

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Permalink Reply by Joseph on February 20, 2013 at 8:50am

Years ago I was hiking in Shenandoah with a couple of friends.

We were maybe a day from a trailhead.  One guy needed to fix his stove and was attempting to remove a large spike nail from a wooden bridge to use as a wrench.  He was using the nail-removal notch on the hatched.  He slipped.  Opened up a pretty good gash on his hand.  We hiked back out and got him stitched up.

If we were a week off the trail...or in a true survival situation with no estimated time of arrival of help, it would probably be best to stitch it I would think, rather than risk constant opening up and re-bleeding.  I do hear about people stitching themselves.  I don't think I'd have the wherewithal to do this on my self now, without novocaine, but in an emergency situation, there are probably many things people push themselves to do.

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Permalink Reply by Paul_of_TX on February 20, 2013 at 10:38am

A guy removes a huge nail from a wooden bridge to repair his stove while on a recreation hike?

Not sure I would waste any of my medical supplies on such an individual. One nail probably will never be missed for a wooden bridge but still it's the principal. Common sense is the first thing that should be packed into any bag before you go out on a trip.

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