My 2 cents
You can buy “Quickclot” gauze on ebay that is impregnated with silver to help combat infection. A deep wound can be staunched with this, and the silver will help decrease infection. The instructions for use are in the packages.

Skin is best closed with small suture, such as 4-0 vicryl, which is absorbable and doesn’t need to be removed later. 2-0 to 0 sized vicryl is also quite practical for deeper tissues and is absorbable. The larger the number with the “0”; the smaller the suture. For example 4-0 is finer than 2-0. Number #1 is very large and I would stay away from anything larger than “0” or smaller than 4-0. Chromic suture is harder to handle and can cause more tissue inflammation. Stay away from permanent sutures like silk unless you are experienced with these as well. Vicryl is easy to use, and not permanent, but slowly absorbed and fairly easy to work with. These are also available on ebay for non-medical purposes such as practice for students. Grab some hemostats and needle drivers for practice as well with the curved surgical needles, which are easy once you get the hang of them.

It is generally safer for non-trained persons to pack any deep wound with the quickclot rather than suture it if you are not sure of the anatomy, as there is much danger of injury to blood vessels and nerves. Also, infection is usually more dangerous if the wound is closed, as an open wound will form granulation tissue, which is highly resistant to infection, and will gradually pull the wound closed. Dilute (1:4) hydrogen peroxide isn’t used too much any more, but I have seen it clean out some nasty wound infections.

The above is not intended for medical advice, but is just my personal opinion of several. Of course, treatment by a trained medical person is always advisable whenever possible.

Regards to all.

Also, I forgot to mention this,
Chromic suture is packed in a liquid and will dry out and becomes unstable over time, while vicryl is dry packed and remains very stable long term, so it is a better choice to have long-term.

Great now I need to find vicryl sutures. Finally a person who knows about the sizing of sutures. Now whats up with the needles and size? Also jagged needle heads and so on.
I like all the suggestions and imput I am going to print off its good to know as much as we can. I know that if the SHTF we are all on are own basically. We have to think about everything we do being careful not to get hurt. I worry most about getting shot. I dont know why, I guess because its actually become a practical thought. A few years ago i would have never thought that I would be concerned about these things at all ever! I should have never read the patriots.

Life has changed drastically for me ,the things that use to matter like a nice car or a new couch dont matter at all anymore, just knowlage and how to gain it and to try to pay my bills.

You know every post here matters once read a mental note is made and could really be of great value one day. And with every post I make i seem to edit more and more you would think I would check it before posting by now.

[edit on 4-11-2009 by saralee] spelling. darn

[edit on 4-11-2009 by saralee]

[edit on 4-11-2009 by saralee]

Originally posted by ofthepeople
Also, I forgot to mention this,
Chromic suture is packed in a liquid and will dry out and becomes unstable over time, while vicryl is dry packed and remains very stable long term, so it is a better choice to have long-term.

So it stays steril ? How would we sterilize sutures , or can that even be done? Most I have expire in a few years.

The QuickClot is probably the best for a deep penetration wound in an emergency. It is simpler and faster in an emergency than deep suturing if you do not have experience. As an example, on an abdominal wound, if your suture accidentally catches and injures bowel, you can die days later of septicemia from bowel leakage.

From their website…

“QuikClot® brand hemostatic agent saves lives by rapidly stopping severe bleeding. It is composed of an inert mineral substance that meets a variety of medical needs and applications, and changing the way we look at traumatic bleeding, by giving first responders and others an additional tool that can save a life.

For the first time in history, we've put the ability to quickly stop severe, life threatening bleeding into the hands of anyone who can tear open a package and follow a few simple directions. And, in addition to products for emergency response, we continue to innovate and deliver life saving products - for the soldier, fireman, first responder and surgeon. When blood loss is the danger, QuikClot® is the answer. Awards Received
2008, June – JEMS (Journal of Emergency Medicine) "2008 Hot Products", QuikClot® Sport™ brand hemostatic agent and QuikClot® Sport™ Silver brand hemostatic agent ANTI-BACTERIAL.

2008, Jan – EMS Product News (Cygnus Publications) "The Top 100 Reader's “Choice Products of 2007", QuikClot® 1st Response™ brand hemostatic agent.

That being said, some vicryl suture for skin and more superficial wounds is not unreasonable. I would get a tapered needle, not a cutting needle, as the taper is safer and will not cut surrounding tissues, although most experienced surgeons use a cutting needle, as it goes through skin easier. The size of the needle is in general proportional to the size of the suture. For skin, I would have several packages of 4-0 vicryl, taper or cutting needle (Small size is “SH”) The larger needles are CT sized, and a couple of packages of 2-0 and 0 vicryl on taper CT needles should do nicely for most common lacerations. Vicryl is easy to tie, almost like sewing thread. Cut the suture a few mm away from the knot, as it will swell slightly, and if you cut on the knot it may be easier to unravel if your knots are not good. Skin sutures can usually be removed in 4-6 days buy clipping the knot and gently pulling the suture out. If left alone, they will dissolve in 6 weeks, but may itch a bit. Deeper sutures should be left to dissolve on their own.

The packages are sterile and packaged with a heavy foil, and although they do have an expiration date, should remain sterile unless opened. The slightly expired ones are much cheaper on ebay (search vicryl suture). I buy these for home use but you could not legally use them in an OR. Its like medications, which must have a mandated expiration date, but if stored well, are often ok even if beyond the expiration dates. Of course a few products will degrade and loose potency, in general the sutures are even more stable. I would not use any product in which the foil has been disrupted.

Once again, this is not medical advice, one should always seek care with a qualified health care provider whenever possible.
Regards.

Interesting responses. Personally, I stock several packs of QuickClot, dermabond pro pen, a 3M surgical stapler and a pint of EverClear grain alcohol for sterilizing and numbing the pain . I'll leave the sutures to the pros. I want quick and clean if there is such a thing when you're in the sticks.

I just wanted to post a follow up note on the QuickClot.

Not all of the QuickClot contains the silver as an anti-bacterial or anti-fungal agent. The QuickClot “Sport” is the one with the silver. It is a bit more expensive, but well worth it in an emergency to have the extra protection from the silver ions.

This may be one time that spending a few extra dollars is worthwhile. This can indeed be purchased from the website, sometimes you can get a better deal on ebay, but that is just hit or miss, guess I was just lucky. I also keep some in the glove box of my car in case of an auto accident.

Just my opinion, anyway,

Regards

My 2 cents again

In general most States have “good Samaritan” laws, which allows persons to give aid in emergency situations without being responsible for a bad outcome. These statues generally also cover the “practicing medicine without a license” part. The standard that is ofted used to judge most of these instances is what a reasonably prudent person would do in a given situation, so unless you do something really crazy, you will probably not be charged with a crime. The laws vary from State to State, (so check your State) but in some states “practicing medicine without a license” is just a misdemeanor anyway.

Getting back to the suturing part, in a clean wound that is fairly superficial, it is reasonable to place sutures to close the wound and stop bleeding. By fairly superficial, this means that only skin and fat are visible inside the wound. . If deeper structures such as muscle, bone, abdominal contents or other structures are visible, the chance for injury is greatly increased with inexperienced suturing and something like QuickClot is advisable until medical help can be obtained. Make sure the wound is clean and free of dirt and debris by rinsing well with clean water, alcohol, betadine or even vodka. Place the sutures about 1 cm deep and about 1 cm apart tie the knots with 4-6 throws (granny knots are fine) and cut the suture leaving 1-2 mm tails. One advantage to placing sutures instead of Dermabond, Steri-strips or other materials is that the wound is less likely to “pop open” again during strenuous activity such as climbing or running.

Hopefully you will never need to do this, but it doesn’t hurt to be prepared.

None of the above is to be construed as legal or medical advice, just merely my opinion. If you have a legal or medical problem, you should consult the appropriate professional for advice.

Regards to all.

One thing I forgot.

It is best to suture only what you can see, unless experienced. If only the skin is open, just suture that, usually a mm deep or so. If the fat is open, it is usually safe to suture down to 1 cm or so.

None of the above is to be construed as legal or medical advice, just merely my opinion. If you have a legal or medical problem, you should consult the appropriate professional for advice.

Regards to all.

It's too bad that surgical knots and suturing techniques is not available any more. Keep looking for a used copy or something similar.

It covers equipment, sterilizing procedures and a number of different suturing techniques including tendons,ligaments and bowel perforations. It really is an interesting read.

Of course I don't expect it will really be necessary for me to ever use any of this information but you never know when an extreme situation will necessitate an extreme course of action.

I know this subject can seem a bit extreme but I think it is a good thing that there are still people who believe in learning and preparing, instead of being simpleminded fools who will always have to be taken care of by someone else.