[topside1]

Morning, quick question. My emergency suture kit will be arriving any day now. What types of anesthestics are available, and what type would you use during surgery? Hope I never need to use this kit, and yes it possibly comes with topical numbing creams, powders or liquids. The breakdown description of the kit’s items didn't mention anesthetics, so where would I buy more to re-supply my field surgical kit? And what would you recommend? I know this question will only apply to a small crowd of homesteaders, but maybe some of you with medical or veterinary backgrounds can offer advice....As always, thanks.

 

[topside1]

Sorry about the terminology, thanks for the humor. Let me make this simpler for you. You are hit in the thigh with a hatchet, your in the middle of nowhere, bleeding profusely, and all you have is you new suture kit. Once the mending begins you realize the pain is overwhelming and you wish you had a topical cream, or powder to numb the wounded area and make suturing easier....What would the over the counter product be?? No bullets to bit on, and I drank the last of my whiskey the night before.

 

[Cabin Fever]

You are hit in the thigh with a hatchet, your in the middle of nowhere, bleeding profusely, and all you have is you new suture kit. ....

Heat that hatchet up in a campfire, bite a twig, and press the red hot metal to the wound....and pass out.

The procedure immeadiately stops the bleeding and kills any infection.

 

[bbbuddy]

Once the mending begins you realize the pain is overwhelming and you wish you had a topical cream, or powder to numb the wounded area and make suturing easier....

Topside, I'm not a doctor or nurse, but I'm pretty sure if it's not sutured within an hour or two, before swelling starts, it is better to just tape/bandage it up. You cannot suture "once the mending begins"...

 

[celticfalcon]

krazy glue for small lacerations will do also

 

[Christiaan]

I just can't see a need to suture out in the field. The risk of infection and gangrene are just too high. You can relieve some of the pain with topical anesthetics or spray cans of wound chiller (don't know if they still make those, they sprayed a rapidly evaporating chemical such as ether on the wound). Then you want to field dress with bandages and get to a medical facility as soon as possible. In case of arterial or veinous blood flow, those will have to be tied off, cauterized or pressure bandaged.

 

[noname]

Sorry about the terminology, thanks for the humor. Let me make this simpler for you. You are hit in the thigh with a hatchet, your in the middle of nowhere, bleeding profusely, and all you have is you new suture kit. Once the mending begins you realize the pain is overwhelming and you wish you had a topical cream, or powder to numb the wounded area and make suturing easier....What would the over the counter product be?? No bullets to bit on, and I drank the last of my whiskey the night before.

I'm sorry, but there isn't one. There are no OTC anesthetics strong enough to do what you wanna do here. As WIHH already stated, these things can have significant adverse effects if not used properly, which is why they're not available OTC.

You've actually got about 12 hours to suture a wound before you're at the point where you can't suture it without debrieding it first.

 

[sisterpine]

Being an ex army medic i have (in the old days) sutured myself on more than one instance. If you clean the wound properly and administer the numbing agent shots (the exact same kind your own doc has given you so you know you are not allergic) the suturing is not a big deal. The only problem I see is that , for me at least, suturing takes two hands and being able to see the wound field. So I cannot suture my own back or arm....i can though instruct another average intelligent person in the needed steps. sis

 

[topside1]

Thank you, noname for finally reading my thread and actually answering my question....
Whether my kit is to be used on some of my livestock or on another person really makes no difference, this kit is valuable in my opinion. My ??? has been answered "there is no OTC product strong enough to elevate the pain during suturing operations". Just trying to learn...Thanks again for the info everyone.

 

[ET1 SS]

I have sutured myself. I have sutured my youngest son [when the Navy Corpsman was shaking too much to be able to do it himself]. I have held the knees of a 18 year old female corpsman whose knees were banging together as she tried to suture on the back of my head, I was trying to steady her, since her shaking was seriously detrimental to her sewing, my head was between her knees. and I have sutured my goats.

I agree that suturing yourself can only be done, when you still have both hands free and when you can reach the spot.

When the 'high' of the adrenaline fades, and leaves you in the 'tunnel', if you are not shaking too badly yourself. Then you can focus through it, to tend to yourself.

Clean the wound, remove projectiles, flush the tissue to try and get any lose gook out, then fold any tissue back together, hold it together and apply pressure. Hold the pressure until the heavy sweating stops. When the flushing from the heavy sweating finally stops, then you can assess how you can bandage yourself.

Suturing takes time, and can only be done later. You have to transport back to your camp, drink as much as possible to replace the fluids you just lost, dig out your ambu-bag, and re-assess if you truly need to suture.

 

[topside1]

Thank you ET1SS, great insight into a potentially deadly dilemma..

 

[motivated]

For small facial lacerations. Clean well and use steri-strips it will heal nicely if your wound is not too deep without sutures.
Please do not use xylocaine with epinephrine on any hand or foot lacterations the epi is a vasoconstrictor and could cause you to lose a digit or toe. 1 or 2 % plain xylocaine works very well for most uses.
I have had good success with super glue just make sure your wound is clean first.
Put a couple of sanitary pads in your kit they are great for pressure dressings or to stop heavy bleeding. Do you have betadine in your kit? I keep a couple of liters of saline for flushing wounds.

Motivated
(I worked as a surgical tech 14 years before going back to school to become a midwife)

 

[ET1 SS]

Topside - The first time I had to suture myself, I was so light headed, sweaty and shaking. I lost a lot of fluid, and even though I was in the 'tunnel' I had a hard time focusing through it. I recall that I did dose myself with a good deal of rum, but that kind of pain can really seem to burn off the buzz. It just never did feel like the alcohol ever took effect.

I am reminded of a time when I wanted to castrate an old goat buck. I had decided that this mean old buck was going into the freezer, but I wanted to marble his meat a bit first. I got some meds from a vet, I put the buck in a stanchion and gave him the drugs poured over a bit of grain. But his excitement over eating grain was so much that his adrenaline never allowed the drugs to calm him. I did castrate him, but he fought me with all his might, I slipped a few times, and I did an awful job of it.

I think that for anyone who has never sutured themselves before; do not drink alcohol. It just does not help. You may need to be drinking to keep from getting too dehydrated, and you really do not want to pass-out. Drink water.

 

[Dixielee]

I don't know if feed stores or vet meds would have injectable lidocaine or not. If you had a sympathetic doctor who would give you a few vials, that would be a plus, but I can't think of any other way to provide local anesthesia to a wound. Maybe ice would numb it temporarily if you could get it.

As an ER nurse of many years, I think I would have a hard time suturing myself, but could do it if I had to. The key is really getting the wound clean. If you have little bottles of sterile "eye wash", you can squirt it into the wound for cleaning. If you have larger bottles, you can stick a needle into the cap several times and squeeze the bottle causing a good rapid flow of irrigant. If you don't have sterile saline, then you can make your own by boiling (I don't have the recipe, but it is a 0.9% solution and I know it is online somewhere), and use a sterile syringe to draw up and flush repeatedly until you are certain the wound is clean.

You will need a sterile field or at least a very clean one to surround your wound. You can carefully open some sterile gauze pads if you have nothing else and surround your wound so your sterile suture does not drag across dirty surfaces.

You can do all the cleaning of the wound with regular gloves, or none at all if needed, but you really should have sterile gloves to work with the suture. The key to suturing is to not make the closure too tight. You want to bring the skin together until it just touches. The tendency is going to be to make it very tight. Under less than ideal circumstances, you would be better off leaving it a little loose and keep it covered with a sterile dressing to protect it. That way if there is a bit of infection, it will drain out and not be locked in the wound to cause a systemic infection, something you really do not want!

There is a lot of good information out there on survival or ditch medicine, you just have to look for it and have it available to you when you need it, so copy it now and have it in a notebook with your supplies.

I know lidocaine creams and gels are available, but you don't want to get them into the wound, and I am not sure how you would effectively irrigate the wound with this in it.

All of the previous posts about super glue and steri strips is valuable, as many wounds will do just fine with those approaches. If you are talking about multi layer wound closures, you are going to need to be prepared with oral or injectable antibiotics as well.

I hope we never have to use this approach, but it certainly does not hurt to think ahead and be as prepared as possible.

I have bought a lot of meds from www.alldaychemist.com to have on hand.
They are an Indian pharmacy and have a wide variety of meds. I have not been disappointed.

If anyone has construed the above info as medical advice, you have presumed correctly, but I can't legally offer it, but feel that anyone that may have what they consider valuable information should not keep it to themselves. I would like for everyone to be as prepared as possible for whatever the future may bring. It is up to the reader to decide if what they read is worthy of note.

 

[ArmyDoc]

The information given below is not intended and should not be considered medical advice. It is general information only, and it's accuracy depends on the individual situation. If you have an actual medical situation, you should seek medical advice from a doctor and follow that advice. I am not your doctor.

Wound care is a very situational dependent problem. Obviousely, a scratch is treated differently than a cut that goes through the skin which is treated differently from a wound that goes into muscle and or bone. But there are basic considerations for any wound.

The original question was concerning the closure of wounds, so that's what I'll try to focus on. The first consideration is how clean the wound is. All wounds must be clean if they are to be closed. Closing a wound that is not clean, will result in an infection. How clean the wound is depends on the mechanism, contamination and severity of the wound. Sharp clean knives and or glass generally create clean wounds. Axes, guns etc generally create very dirty wounds.

It is relatively easy to clean a cut that is just through the skin. Large amounts of clean water (ideally sterile, but distilled with a little betadine works too) can be used to wash it out if done immediately or within a few hours of injury. Generally, you don't want close even a "clean" wound if its been open more than 6 hours, with few exceptions.

Deep wounds are better off left open, and treated with wet to dry packing. Use clean gauze moistened with sterile water or saline (again, distilled water works in a pinch) and place it in the wound, filling it from the base to the top. It just has to fill the cavity, not be "packed" in. Cover with dry guaze. Over time your body will fill the wound in - it takes time but the body will close even very large wounds given time.

As for local anesthetics, forget topicals. They don't penetrate very deeply, or very rapidly. Those that work halfway decently aren't available to the general public, and even they aren't all that great. They are limited to small cuts. They don't make much of a difference for suturing larger wounds, though they may help in a child so that they don't jump as much for when the local is injected. Local anesthetics such as lidocain are also generally not available to the public. They can be cause cardiac problems if used in very large doses, or if injected into the blood stream, but are generally very safe for local injection. (except in the rare patient with an allergy) They take effect in 30 seconds or so in the area immediately around the injection site, and longer the further away you get or the larger the area being injected.

As for bleeding, direct pressure is the key. All bleeding even arterial bleeding can be stopped by direct pressure. The problem is that arterial bleeding is likely to restart when the pressure is released. Arterial bleeding often has to be stopped by ligation of the injured artery. Thankfully, arterial bleeding from a major artery is rare.

Most bleeding is veinous, or at wors from small arteriols. Holding direct pressure to the wound for 5 minutes (look at a clock, it seems longer than it is) will stop the bleeding from the vast majority of injuries. By direct pressure, I mean direct pressure on the bleeding point sufficient to controll the bleeding. A lot of times people make the mistake of putting lots and lots of dressings on and then holding pressure. This diffuses the pressure away from the actual injury, which fails to stop the bleeding. A smaller dressing and /or direct pressure on the bleeding site will do the trick.

Hope this helps.

 

[topside1]

Great post Army Doc, I have made notes and appreciate you time...