# Survival > Bushcraft Medicine >  Suture Kit Revisited

## Batch

Alright, I know the consensus on this for this forum. You should not normally suture or staple your wounds in the field.

How, I was injured (you can skip this)

I went to Big cypress National Preserve. They have added "amenities" to the camps at Bear Island. They poured a concrete pad and put a picnic table on each site. They added a brick shift house every so often. They also added fire rings. One of my buddies set up his own camp and took a bigger fire ring from another camp. Because it was bigger and the grill section swung out of the way. The problem was that he put the bigger fire ring right up against the smaller ring. With a fire going you could not see the unused ring. His daughter was backing into the fire which had flame up about 6'. I lunged forward to stop her and hit both of my shins on the unused and unseen fire ring. To catch myself from falling into the fire I caught the edge of the used fire ring. Anyway, the girl was stopped with my other hand and is fine. My hand received 2nd degree burns and was immediately iced down. What I thought was a couple of skinned shins was revealed to be a little worse than I thought. I had a laceration on my both shins.


It was the busiest I have ever seen at Bear Island and one of the people that stopped by our camp to visit knew of a nurse that was in a camp a little ways off. She also happened to be a nun and in camouflage. LOL We had already cleaned and bandaged the wound by the time she arrived. She unwrapped it and re-cleaned it and tried to close it with butterfies. She said I needed to go get stitches. she was qualified to stitch the wound but no one had sutures. 

Someone else heard the cut was real bad (it wasn't) and called the ranger station. Two rangers responded and one was a trained medic. He also said it needed stitches and that he could have stitched it but had no suture kit. We had lidocaine and 0.9% sodium Chloride injection syringes we were using to irrigate the wound. But, no sutures.

We drove about an hour to the nearest hospital and got sewed up with 8 stitches. took a little over 4 hours to get back to camp. 

Would you have let them suture you at camp? Is this an instance where having a suture kit would have made sense?

I put links rather than pictures so as not to gross anyone out.

Unwrapping the first bandage so the nun can access the wound.

http://i4.photobucket.com/albums/y13...s/DSCN0051.jpg

The cut

http://i4.photobucket.com/albums/y13...s/DSCN0052.jpg

The burn, we already had silver sulfadiazine and bandages.

http://i4.photobucket.com/albums/y13...s/DSCN0053.jpg

Camo nun re-bandages. Right as she was finishing the rangers showed up. 

http://i4.photobucket.com/albums/y13...s/DSCN0054.jpg

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## TresMon

Sounds like it could make a ballad type song "Beer & bandages!"

Glad your okay.

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## Willie

Wow that looks pretty bad. Glad it wasnt alot worse!

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## crashdive123

To answer your question - yes.  This really is the only reason I would want to carry a suture kit - if it was needed and there was somebody qualified to use it.

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## RandyRhoads

> Someone else heard the cut was real bad (it wasn't) and called the ranger station. Two rangers responded and one was a trained medic. He also said it needed stitches and that he could have stitched it but had no suture kit. We had lidocaine and 0.9% sodium Chloride injection syringes we were using to irrigate the wound. But, no sutures.


Medics can't suture anything. Out of their scope of practice.  And i'm willing to bet their lidocaine was for cardiac issues not local anesthesia. There's a good chance the nurse couldn't either, depending on what state you were in. Even if they could in a hospital environment under a physicians license, the could not do it legally it that situation.  I wouldn't let them . Only someone I knew and trusted, or myself, providing there were antibiotics available, and in an emergency situation that prevented me from getting to a hospital. 


After looking at the pics I would have been more concerned with the partial thickness burns. Those are in an area of high function.  Looks like a decent laceration, but if I was in your situation I would have put a pressure bandage on, and either gone to the hospital, or continued on. Definitely no sutures there at camp. Bleeding could be easily controlled, and it wasn't in an area of high function. In fact the only reason I would see for suturing at all would be to prevent an infection, or unless you had a thing against scars.

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## Batch

The Lidocaine is from a cancer my friend whose son has a pretty bad case of cancer.  He has a thing in his chest that requires it as a maintenance feature. 

If you could see my scars... LOL. I ain't worried about scars at all. My right leg was almost completely ripped off when I was 17. I have had hundreds of stitches in just that instance. Most people who see me without a shirt think I am a bullet magnet. I am a well scarred individual. 

I wasn't planning on holding them legally responsible. I have a script for the same pain killer I would take for my back. I have a script for an antibiotic that I won't take unless I show signs of infection. 

The areas of high function were used the rest of the weekend to drive the UTV. No popped blisters.

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## RandyRhoads

Ouch. Love the pic with everyone standing around continuing the beer drinking. Makes me realize I need to go camping .

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## 1stimestar

Oh man, those burns are going to hurt.  As far as the stitches go, if it were someone I knew, like has been said, I would.  My best friend is a PA so it's likely I would know the person with me was able to stitch.  You can also get medical grade super glue for things like that.  It works great in skin that doesn't move a lot like a joint. Don't ask me how I know hahhaha. 

Oh one thing.  I noticed you said you iced the burns down.  Don't put ice or even ice water on burns.  Cool water only.

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## Batch

The bleeding wasn't a real risk. The burns are second degree and will probably be gone completely healed by the middle of next week. By week end at worst.

What damage was or might be done with ice or ice water? 

My understanding is that the burn continues until the temperature is dropped below the damaging level. I was regulating my hand so as not to risk damage do to cold. 

We had more folks than needed working on me  for a cut and a burn. So the rest of the guys finishing their beers is hardly note worthy. The stuff in the mason jars would probably be down right scandalous. LOL

This wouldn't ever have been more than an inconvenience. I was asking about the time saved on a trip by suturing in this circumstance. I did not like having to leave camp for something so simple. I would never have gone to the hospital for those burns. Like I said we had the same exact cream and bandages. I also had quick Clot. But that wound wasn't leaking fast enough in my opinion to justify its use.

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## 1stimestar

Yes you want to cool the area but you don't want to restrict circulation and that is what ice does.  

As far as the cut goes, it's a good thing it did bleed a bit to help clean it out.  Have you had a tetanus shot within the last 10 years?  I know those fire rings get rusty.

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## Kortoso

Whacked open my friend's hand once. Two of my other friends there were Navy corpsman, and although they had all the training and suture kits galore, they looked at each other and said "there's no sterile field", so we drove our victim to the ER where he got stitched up.

You had to walk out, so that was probably an important factor. Hope you didn't tear the stitches in doing so.

I have two wounds on my left leg, each would require 10 stitches. One I had in jr high school, had stitches, and there's still a bit of a scar. 
The other one was many years later, I treated it myslef at home without stitches (no insurance) and it looks about the same as the other.

Many small wounds don't really need stitches unless you need them to heal up real pretty.

BTW, drinking alcohol interferes with blood clotting.

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## Rick

Under your exact conditions I would have gone to an After Care or ER, too. You were in an extremely dirty environment, under flashlight trying to ensure a wound is clean enough to suture. Not a good recipe for a clean wound.

Yes, I carry them but their use would be very restricted. There are several other alternatives that can and should be employed first. There is a reason the rangers don't have sutures with liability being only one. IMO.

Hope you get better soon. Burns are the pits. Bravo, too, on saving the girl!

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## Batch

> Under your exact conditions I would have gone to an After Care or ER, too. You were in an extremely dirty environment, under flashlight trying to ensure a wound is clean enough to suture. Not a good recipe for a clean wound.
> 
> Yes, I carry them but their use would be very restricted. There are several other alternatives that can and should be employed first. There is a reason the rangers don't have sutures with liability being only one. IMO.
> 
> Hope you get better soon. Burns are the pits. Bravo, too, on saving the girl!


Thanks, Rick. I can see it probably was just as well to go into town and get stitched up.




> Yes you want to cool the area but you don't want to restrict circulation and that is what ice does.  
> 
> As far as the cut goes, it's a good thing it did bleed a bit to help clean it out.  Have you had a tetanus shot within the last 10 years?  I know those fire rings get rusty.


Yes, I had tetanus two years ago. I was wondering though, how much dirt or rust would be transferred. I had long pants on and the pants did not rip. This is one of those impact on the skin in a boney part of the body deals.

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## Rick

I would bet that if you could look at the wound under a microscope you would have been shocked. You would have seen a ton of dirt transferred through the weave of the material directly into the wound. Not to mention fibers from the pants, hair and dead skin cells from your leg not to mention a host of bacteria, viruses, molds and mildews that occur naturally on the skin as well as any critters on the burn ring that would have passed through the cloth.

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## RobertN

Those burns looked nasty especially on the palms of the hand. As far as the cut, nothing some duct tape and super glue can't fix.  :Smile:  Actually if you could get the bleeding stopped then you might have been able to use a butterfly bandage to pull it together. Although I have heard of super glue being used to close a cut.

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## BENESSE

I would have some trepidation about super-glueing a cut that I am not sure is totally clean. If an infection sets in, you'll be in a world of trouble. Duck tape and butterfly bandages make more sense, IMO.

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## cleans up

Here's my 2cents.  Suturing isn't all that hard- pretty similar to sewing anything else really.  The tough part is know when and when not to.  This takes a degree of knowledge well beyond the scope of this or any other forum.  Just a few of the things you need to keep in mind- blood vessels and nerves, where are they? are they intact, do they need to be?  How many layers are damaged, do you need to sew them up individually or is all at once good enough? Infection, is it really an issue- yup.

So in short  I wouldn't sew someone in the field unless it was well inside my training/ experience.  Most wilderness FA course will tell you that packing a wound and transporting even if it takes many hours is the far better approach.  This allows you to keep tabs on things like bleeding and gives someone with the proper training the opportunity to close things properly.

N kudos to the camo'd nun!  and the rest of the crew- looks like you all made the best of a bad situation

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## natertot

I agree with cleans up. I would disinfect the wound, pack it, and use duct tape for butterflies. If someone with a fair amount of training says get stitches, I'd go to the ED and let 'em check it out.

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