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Dangerwolfe

Suturing: an ounce of prevention

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I wish you all would tell my doctors that in fact a surgery recently 2 years ago

 

they used betadine and sent me home with staples and tape and betadine and bandaging

 

so tell it to these guys I have had them scrub my wounds with a disposable fingernail brush

 

so your saying I can sue these guys right? after I was as blue as one of them little smurf's

 

I hate to tell folks but I would not let most Dr's near my dog my vet does better needle work

 

REALLY my dog had a line almost indistinguishable from the flesh around it my scar is almost a

 

half inch wide and still has the blue stain under the skin from Betadine I have seen people released from

 

numerous hospitals And I know I could have done a better job and they still got some pretty FuGlY scars.

 

If your a man they do not seem to care a woman they have more stitches

 

for the same length scar then they tell you they can refer you to a

 

plastic surgeon OH I think they really mean I did not care enough to

 

handle it right the first time like no internal suturing not enough sutures

 

for the size wound and no tape but go to a plastic surgeon and that is what

 

you get more sutures and a lot of tape and drugs to help with inflammation.

 

and infection the same stuff you could have gotten from your original

 

doctor.

Edited by juzcallmesnake

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I wish you all would tell my doctors that in fact a surgery recently 2 years ago

 

they used betadine and sent me home with staples and tape and betadine and bandaging

 

so tell it to these guys I have had them scrub my wounds with a disposable fingernail brush

 

so your saying I can sue these guys right? after I was as blue as one of them little smurf's

 

I hate to tell folks but I would not let most Dr's near my dog my vet does better needle work

 

REALLY my dog had a line almost indistinguishable from the flesh around it my scar is almost a

 

half inch wide and still has the blue stain under the skin from Betadine I have seen people released from

 

numerous hospitals And I know I could have done a better job and they still got some pretty FuGlY scars.

 

If your a man they do not seem to care a woman they have more stitches

 

for the same length scar then they tell you they can refer you to a

 

plastic surgeon OH I think they really mean I did not care enough to

 

handle it right the first time like no internal suturing not enough sutures

 

for the size wound and no tape but go to a plastic surgeon and that is what

 

you get more sutures and a lot of tape and drugs to help with inflammation.

 

and infection the same stuff you could have gotten from your original

 

doctor.

Hi Snake,

 

My mom was a Chief RN (instrutor) for nurses for many years. Dealt with the nasties like minding the stumps/changing the dressings for amputated limbs, etc. She told me FLAT OUT that only 25% of the Medical Professionals are competent, 50% don't care and just get by and and a full 25% are out-right dangerous! So, you have a 1 in 4 chance of getting a some butcher/hack treating you......and only 1 in 4 of getting good treatment.....

 

I am not a doctor but from what I understand, Betadine is only for "surface" use, such as creating a sterile field around the point of entry before an incision.....in the case of a dirty wound it "can" be used to flush the wound but only in diluted (perhaps 10% strength) form..... Afterwards, the the Betadine itself must be flush out with clean water/saline or it will KILL cells exposed to it for a prolonged period.

 

Snake, if you have blue scarring under your wound, then it was NOT cleaned correctly..... My suturing kit/video says the following about cleaning a wound and I quote...

 

"Remove all glass, soil, plant material, etc. Soil remaining in the wound will cause traumatic tattooing (very difficult if not impossible to remove at a later stage). If necessary brush the wound with a bristled brush combined with a mild soap solution, i.e. Savion."

 

You may also have what is called a "hypertropic scar" that may be the result of mild mechanical or bacterial irritation of the wound during the healing process, or wound "dehiscence" (the edges of the wound pulling apart) which can also result from sloppy suturing.....

 

Again, I am not a doctor but it sounds like you experienced a shoddy cleaning and repair of your injury, followed by the improper use of Betadine which may have damaged the cells along the wound edges, thus dehiscence, resulting in a hypertropic (Keloid) scar.....

 

Not sure where your wound was located, but if the wound was in an area subject to tension like over a joint, etc. it would also require different suturing techniques, materials, etc. than say on your forearm....or again it would dehisce (pull apart)....

 

My guess is you signed away your right to sue....

 

Knowledge is power brother.

 

Wolfe

Edited by Dangerwolfe

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Wolfe

 

I appreciate your time to answer my RANT and I think your quite right about the ratios of doctors competency

 

My scar is mid thigh to just above the knee anterior so I could understand a bit of dehisce but they used

 

so little to hold it together that was the main problem.

 

All I can say is once they knock you out more than likely your gonna wake up screwed BLUED and after you healed TATTOOED LOL

 

and yea they got you over a barrel do not sign they do not treat under certain circumstances I always thought that was a form of extortion Odd considering if I drive or walk past an accident and do nothing I can be

arrested for failure to render aid but doctors they got all kinds excuses and they get by with it.

Although I have not kept up am I sure my EMT credentials would be brought into it if it went into a legal arena.

 

thanks again Wolfe

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Wolfe

 

I appreciate your time to answer my RANT and I think your quite right about the ratios of doctors competency

 

My scar is mid thigh to just above the knee anterior so I could understand a bit of dehisce but they used

 

so little to hold it together that was the main problem.

 

All I can say is once they knock you out more than likely your gonna wake up screwed BLUED and after you healed TATTOOED LOL

 

and yea they got you over a barrel do not sign they do not treat under certain circumstances I always thought that was a form of extortion Odd considering if I drive or walk past an accident and do nothing I can be

arrested for failure to render aid but doctors they got all kinds excuses and they get by with it.

Although I have not kept up am I sure my EMT credentials would be brought into it if it went into a legal arena.

 

thanks again Wolfe

 

No worries Snake,

 

You have lots of great info in your posts so just sending the elevator back man.

 

Poor/sloppy medical treatment I find especially galling given what is charged for it these days, just no excuse for it. If they did not put in enough stitches/staples to keep the edges together, plus irritated the wound margins with Betadine then not surprised it pulled apart/didn't heal correctly and you have the scars.....

 

I do respect the medical profession, but have had both competent and incompetent treatment myself so I stay as far away from the doctors office as I can. Fortunately, never been in the hospital or had anything but very minor out-patient surgery (for ingrown toe-nails) and yes they screwed that up, also an incompetent dentist/orthodontist really screwed up my teeth/jaw as well when I was a kid.....

 

My wife started to get episodes of severe dis-equalibrium like being on a carnival ride, followed by a drop in hearing in one ear....after SEVEN different doctors, some recommending surgery before she was finally correctly diagnosed....but not before she went completely DEAF in the ear as it was by now 2 years into the problem and too late to treat it......not fun for a young woman in her 30's....

 

More recently, Mom had a "routine" knee replacement surgery.....thing swelled up like a football, took her over a year to recover and she suffered terribly. Lost so much weight she probably only weighed 100lbs.....Come to find out the implant is now slightly cocked.... My guess is it got infected but you know how it is, the "big wall of silence" from the doctors, no one rats anyone else out....my guess is she got some kind of infection they will never admit to...

This was all in the USA mind you. The same can happen over here in France but the Medical system works a bit different...things aren't so rushed.

 

Now for my own family, I just study their medical issues/treatments so at least we go in educated. I know what the options are and where the screw-ups can happen so I'm extremely particular with whom we see and what is done....

 

EMT? Really reget I didn't get mine when I had the chance. I was riding with the paramedics as a teen through a local regional occupational program, got my advanced first aid, saw some "jelly donuts" but changed directions....picking it up over here I'd need to join the Red Cross and I don't have the time....

 

Wolfe

Edited by Dangerwolfe

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Suturing is a skill like anything else. Anyone can learn to do it. It is learning the judgement of when to do it that has to be learned. As someone who has done a lot of suturing, I am a Prolene fan. Its tissue reaction is equal to that of stainless steel wire. This is good if concerned about cleanliness of wound, which is paramount first and foremost. Catgut or Vicryl or Chromic, all absorbable sutures, which can be use for subcutaneous closure (fat) requires tissue reaction to dissolve and is adding another foreign body to the wound, thus, Prolene, with minimal to no tissue reaction is a good choice. Some prefer Nylon (Ethilon) but it has more tissue reaction than Prolene, but still a good choice and less expensive.

Superglue is fine for straight wounds with no tension on the skin lines and is to be put OVER the wound NOT in it. SteriStrips (modern day butterflies, duct tape would work) is a great way to close a wound with little to moderate tension on the skin lines. Tincture of Benzoin is an adherent that you put on the skin that will help the tape adhere better and longer.

Vessel ligation is getting more advanced and direct pressure is still a good recommendation for controlling most bleeding

But, again, the key is irrigation with sufficient force to remove the dirt.

 

sawbones

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I have not tried it, but have been told that opening a capsule of Benadryl (Diphenhydramine) and putting it in the wound is effective as an anesthetic. Sometimes, if you can treat the wound in the first 15 minutes there will be no pain, without anesthetic.

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My family has used kerosene for cleaning and soaking wounds for generations. It always seems to work wonders for cleaning and "preserving" (keeps the flesh fresh and oxigenated looking, vessels and such alive, and seems to prevent infection and speed healing) the wound. I would like to know Dr. Bones' opinion on this as any other doc that I mention it to is appalled and thinks I'm crazy for even asking.

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I am a retired Navy Chief Corpsman and I can't even quess how many times I have surtured wounds, so I know I can suture very well. I was 26 when I got my first sutures, and as a kid, my parents were firm believers in all types of burning antiseptics and tape! (I know some of you know what I am talking about) In fact, my 92 year old great grandfather was teaching me how to carve wood when I cut myself. He took me into the shed, and stuck my finger in turpintine, which almost caused me to piss my pants! The cut never got infected and healed great. So, in a survival situation and only a survival situation, I would suture a wound.

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My family has used kerosene for cleaning and soaking wounds for generations. It always seems to work wonders for cleaning and "preserving" (keeps the flesh fresh and oxigenated looking, vessels and such alive, and seems to prevent infection and speed healing) the wound. I would like to know Dr. Bones' opinion on this as any other doc that I mention it to is appalled and thinks I'm crazy for even asking.

 

Welcome Bumpkins to the forum hope you enjoy it.

 

I think I read that the NEW kerosene is not coal oil of old and it was not advised but if you research it

let us know I had thought to but I didn't get to it.

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Okay Folks,

 

I FINALLY had the chance to finish all the lessons in the suturing kit from Apprentice Doctor:

 

http://www.amazon.com/The-Apprentice-Doctor-Stitch-Suturing/dp/B001CTEOZU

 

Read the customer reviews on Amazon for more info.

 

I can tell all of you, done properly it's a time consuming effort to complete the lessons but well worth it. I have new respect for surgeons....very tedious to do the stitches correctly.

 

Any questions, just PM me.

 

Wolfe

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There's also some pretty quick techniques developed that have proven useful- using hair-twist-glue closures and simply using strands of hair and tying the strands down- useful in cases of long hair on the scalp. I use a free website called emedicine.com. This website is free and gives excellent information and sometimes videos for various procedures such as shoulder reduction after dislocation. As an ER physician, I can tell you that the scalp almost never gets infected as the blood supply is so extensive. Contamination with debris should be avoided, but tap water or boiled water can be used to irrigate and cleanse wounds. Any visible debris should be removed before closure, and heavily contaminated wounds should be left open for 48-72 hours before performing a "delayed primary closure"- closing at this point is primarily for cosmetic purposes however, and there is nothing wrong with leaving the wound open longer. If you are talking about doing an arterial ligature, that is an entirely difficult question to deal with. If you have definitive surgical care that can manage down the road, it makes sense to due an arterial ligature if you know what you are doing. Often, you can do more damage than good, however, and it is better to just hold pressure and perform a pressure dressing. Hope this helps.

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There's also some pretty quick techniques developed that have proven useful- using hair-twist-glue closures and simply using strands of hair and tying the strands down- useful in cases of long hair on the scalp. I use a free website called emedicine.com. This website is free and gives excellent information and sometimes videos for various procedures such as shoulder reduction after dislocation. As an ER physician, I can tell you that the scalp almost never gets infected as the blood supply is so extensive. Contamination with debris should be avoided, but tap water or boiled water can be used to irrigate and cleanse wounds. Any visible debris should be removed before closure, and heavily contaminated wounds should be left open for 48-72 hours before performing a "delayed primary closure"- closing at this point is primarily for cosmetic purposes however, and there is nothing wrong with leaving the wound open longer. If you are talking about doing an arterial ligature, that is an entirely difficult question to deal with. If you have definitive surgical care that can manage down the road, it makes sense to due an arterial ligature if you know what you are doing. Often, you can do more damage than good, however, and it is better to just hold pressure and perform a pressure dressing. Hope this helps.

 

Hi Jeremy,

 

Thanks very much for the information and medical advice, great to have the professional opinion of an ER physician. I am very fortunate to know the town doctor in our village on an acquaintance level, been over to our house for drinks, etc. He was impressed with the techniques in the suture kit and will probably borrow it from me to brush up. I'd like to get him on my "prepper team" but as you can imagine it's a slow and delicate process.....

 

Yes, I did have some questions about arterial ligations, obviously they must be temporary..... I can't imagine you can just tie off an artery and then stitch up wound without having to go back in and somehow re-connect it without killing tissues....I need to study this more.

 

I will bookmark emedicine.com for reference.

 

Cheers,

 

Wolfe

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Hi Hikinged,

 

That's an excellent book. Our book "The Doom and Bloom Survival Medicine Handbook" is different from it in that our book assumes that there are NO modern medical facilities accessible for the long term. It never ends a section with "and go to the hospital" because it assumes YOU are the end of the line when it comes to the medical well-being of your group.

 

Dr. Bones

 

I don't have The Doom and Bloom Survival Medicine Handbook yet. However, I did take their class on suturing and it was FANTASTIC. Dr. Bones and Nurse Amy were excellent instructors. They were well prepared, we (the students) were well supplied, and their presentation was excellent!! They gave excellent one on one help. I only wish they did more classes with a wider array of subject matter.

 

After re-reading my post... it sounds too sickening sweet... too much praise... but the class was really that good.

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