Added: 2 years ago
From: USNERDOC
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  • quick clot ftw, this is not happening in the field

  • @untouchblz - don't understand your comment ...

  • @untouchblz quick clot will not close a wound...sounds like your a bit confused on the use of sutures.

  • Do I go clockwise or counterclockwise when wrapping the thread? What type of suture I should carry for backpacking into extreme areas, sometimes days away from an ER, & even out of the country. We sometimes go with children too. I see all kinds of different type/shape needles, & they all come in various mm with different kinds of threads, even ones that dissolve. Can you offer me some suggestions as to which one to pick? Can I put a little Neosporin in the wound before closing it? Thanks Doc!!

  • Hey USNERDOC, thanks so much for this series of videos. Got turned onto it from Nutnfancy's vids.

    I have learnt a lot about suturing from watching - to think I used to think it was a long running stitch! So, just to double check the 2-1-4 point, first knot is 2 wraps around the needle driver, then FOUR more knots with only one wrap around. Always going Long over to short. So 5 knots in total on each stitch - is that correct?

    Again, thank you so much for making this series.

  • Very good job. I was gonna make a similar vid, but after watching yours I have to fav'ed and recommend as well. Would have liked a little discussion on a fenestrated sterile towel and maybe a field surgical kit being used, but I understand that you were going for the "how to do it in the field" scenario and maybe they only have the suture with them. What do you recommend as a OTC topical anesthetic? Again good job.

  • would you use lidocaine as a general anesthetic before suturing the wound?

  • Fantastic video! This has removed a lot of mystery I had about suturing. Thank you!

  • This rocked!!! BBQ up the leftovers Doc...make great split pea soup too, sutures and all.

  • doc sorry because this might be a stupid question but on the first stich (2-1-4 , on the "2") why do I have to go through the wound at the first pass ? Why not behind the wound like the rest of the stiches ?

  • were can u get Suturs

  • Doc, great Vid! I am a Paramedic in OKC, tactical trained. I am recommending this to fellow co workers

    Dumb question. In a SHTF situation, what would happen if you used different knot? Like a few square knots? Is that a dumb question?

  • @1TacticalMedic - not a dumb question . . . what you are watching results in a set of stacked square knots. I used to teach this course to the corpsman in the Navy . . . some of the best fun I ever had was working with those guys . . . very "gung ho"!

  • Doc, great Vid! I am a Paramedic in OKC, tactical trained. I am recommending this to fellow co workers

  • Great vid. Brings back some vague meories of my time in a vet hospital. (nearly fainted my 2nd & third time lol)

    A couple "quick" questions:

    1 - what if you have a "seeper"? Do you keep waiting/pressure/etc? or do you close over it? Stiptic/quick clot?

    2 - I've seen a couple REALLY ugly wounds in the field (among them - 2" long & .5" deep on the calf) that were closed with bandage & duct tape. What type of wound would realistically need this? (I would avoid stiches like the plague) thx!

  • Great set of videos. I am a new subcriber to your channel. Love your stuff. It is nice to see a fellow TNPer from Oregon. Keep up the good work. Thanks

  • Great video Doc. Thank you for this series. Would you know where I could get info on emergency dental care. ie broken, crack tooth etc.

  • Doc, that was first-rate practical hands-on instruction, ...and explained very well too! Nice job on the video and audio as well. Thanks for making this video Sir!

  • lol, a pig's foot, where would u get one of those

    is that a Casio watch?

  • @john1112112 - pigs foot from the local market . . . stay tuned for a "pigs foot friendly alternative" suture simulator! ;-0

    Yes, that is a Casio watch.

  • @USNERDOC lol

    i recognized it because my dad wears the same watch

  • Doc..you say that you should start in the middle, but what if it is a gaping wound?

  • @ayres390 - you still start in the middle and work your way to each end. Otherwise you end up with a "dog ear", i.e. last bit of wound with asymmetric edges that don't close cleanly.

  • Thanks again USNERDOC. Got the answers I was lookign for in your video. Just want to find the best website to roder a couple suture kits. ever hear of medvets website?

  • Excellent series. The only thing I would say which might be a equipment issue...its hard to see the mono-filament and needle to see the motions,loops,knots. Very good and a excellent series which may save lives in the field. *****

  • I thank ya for the series Sir! You've got another subscriber! Quick question though. Is there a brand you would recommend for a kit? I've got some made by Ethicon but I wouldn't want to make a bad situation worse by using a poor brand. Anywho, keep up the great work.

  • @loadmastergod - Ethicon is great. Thanks for the kind comments.

  • Excellent overview, Doc. Good stuff.

  • doc what kind of medicine are you going to inject and how many cc thanks

  • Number 4 wouldnt load!! Dont know why? The other 3 worked just fine! Great series disappointed cant watch 4!

  • Once I found this on your channel. The level of awesomeness went up from your already high caliber of awesomeness. Thank you for sharing your professional knowledge. Love your videos :)

  • That was very informative. Thank you for sharing your expertise.

  • Where did you find a pig's foot?

  • @Mrcaffinebean - LOL . . . good question! You can get them at the grocery store.

  • Very informative! Thanks for putting in the time to educate us!!

  • Awesome series Doc!

    Thank you show much for sharing this and helping educate the layperson. I am in the process of updating my first aid gear and have decided to add suture kits to them (if I can find some!).

  • I'm going to have to study your series when I get the chance. This is important first aid information that I really have to know.

  • I understand that there are different types of knots and suturing patterns for use on wounds dependent on what part of the body the wound is on. Could you explain the differences of the different types of suture patterns and which type to use on which part of the body? Also, could you explain the differences between reverse cutting sutures and plain round sutures as well as all the various other types of sutures? It would be helpful to know which type of suture to put in your pack.

  • One poster asked you about which needle driver you would use if you indeed did carry one in your kit and you didn't answer. I am interested in this answer too.

    Finally, I absolutely loved your video. You are very skilled and taught me some things I have never thought of during the suturing process. Love your channel and will watch all the videos.

  • @Vandy1212 - I try to answer as many posts as possible. It is sometimes very difficult as I gat a lot of email every day from multiple sources, including YouTube. If I were to use a needle driver in my kit it would be a standard needle driver. I did include a standard needle driver in my Level II kit. Many thanks for the kind words and support!

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  • Sir:

    This is just me. I think I would have POURED some of the full strength

    Betadine on the Leatherman before grabbing the suture needle, or, at least have wiped it down with alcohol or somehow decontaminated it.

    Also, I could be totally wrong about this, but wouldn't an isotonic solution be better for irrigation? Water to me would macerate the wound. Wouldn't NS be better? If you don't think so, I'm open to an education..I love this stuff.

  • @Vandy1212 - remember in the field at best this is a clean procedure. It is always good to clean any instrument in the field before using it. Plain water is perfect for irrigation of wounds. You don't need to use normal saline (NS) for irrigating a wound. Besides, I doubt saline is going to be readily available in the field. Thanks for watching!

  • Thank you so much for sharing your knowledge with us. I hope I never have to use this knowledge, but if I do, I'll have you to thank.

  • Outstanding series Doc....thankyou.

  • Outstandig quality of Information. This is really helpfull. Thanks a lot.

  • i know this is probaly a very stupid question but can someone who can not get the suturing kits for whatever reason or dose not have them when they need them use mono fishing line or something similar and if so what type of neddle would the use or say like the mono leaders for a fly fishing pole thank in advanced john

  • @bigjohn20081983 - suture material is readily available to the general public via many sources, including REI which markets the Adventure Medical Suture Kit. That said, there are a always expedient alternatives to anything, including wound management. Suture is essentially a monofilament nylon material with a swaged needle. Fishing leader would be a reasonable alternative w/ a small curved carpet needle. Not my first choice of course, but then a gain, suturing in the field is not a first choice.

  • i cant watch past 1:35 either.

  • Am I the only person that can't watch past 1:35 before the video hangs?

  • great stuff. I'm truly motivated to save some pig's feet! Semper Gumbi! :)

  • @ USNERDOC - I was thinking about this and since I dont do this everyday and being in a not ideal condition is there something I can put in my LVL 1 kit that will allow me to numb the area where I would be doing this so the person is not moving everywhere?

  • Not that I am aware of . . . and you bring up a good point in that this procedure for most will be done without anesthetic. It can be done but will be painful. This is another reason that this needs to be considered for a last resort procedure under austere conditions, i.e. not able to evac to or no medical resources available.

  • get some .5 percent plain xylocaine and some 25 guage needles or diabetic needles and you can numb it up.

  • Hi! Thanks alot for this video, super! 1 question, how deep do you put your stiches? In the skin or just below? Thanks /Niklas

  • great series and this was one area of my Level 1 kit I needed some over view on. Thanks for taking the time to make this series and I think I will be doing some practice on some pigs feet my self. Thanks again.

  • two questions:

    where would I get suture material? I thought it was regulated and only accessable to doctors and vets?

    and couldn't you just carry a suture driver in your kit? it could have other uses too like foreign body removal(splinter).

    I don't think it would weigh that much more and you'd have what you need, not having to improvise with a possibly dirty multi-tool.

  • I get a lot of questions on where to get suture material, so keep an eye peeled for a source list soon to posted.

    You certainly could carry a needle driver which would be a good option. They don't weigh very much but would add a bit of bulk to you kit as well as some stiffness. Needle drivers would not make a very effective splinter removal tool. Since aneedle driver and multi-tool would be need to be wiped down with an alcohol pad before use, I doubt you would gain any increased cleanliness.

  • Thanks for the great comments and for watching!

  • Dr. Pruett, thanks for taking the time to make this series on suturing...very succint...warm regards.

  • You are more than welcome! Thanks for the support.

  • ...I feel it is essential that everyone be exposed to such basic medical techniques....Thank you for the time and effort!!!!

  • I agree . . . I see this as a life skill . . . basic understanding of first aid is vital. I'm posting these for those that want to push the envelope for difficult situations.

    Thanks for watching!

  • Thanks a thousand times.

  • You are more than welcome!

  • wow this was a really good series. thanks for the effort

  • Thanks! I appreciate the comments and support.

  • First of all great videos, this series and the vacumm sealing bags.

    My question is in looking online for suture materials I found "expired" and "non-expired" materials. I understand the expired ones can be used for practice, but my question is exactly what causes a suture to become expired? How can a metal needle and short length of filament expire?

    Also what would be the risks (if any) in using expired ones in actual use?

  • Thanks for the comments!

    Regarding expiration date, given the standard caution about expiration dates, one always has to use good judgement and make choices that make personal sense. That said, I personally would have no trouble using expired suture material for remote wilderness situations. I think this makes sense, especially when I read about guys thinking of using dental floss, thread, fishing line and 550 cord filaments! Hope that helps.

  • this is just me, but I think expiry dates are more for absorbable sutures like catgut, since it's made from a natural material, possible to rot and lose it's necessary strength to hold a wound closed, could also cause infection by attracting bacteria to the rotting suture.

  • Good point. They all have expiration dates, so I think you just have to use good judgement. My recommendation is to use the monofilament products such as nylon or prolene. Given good common sense, I don't see how an expiration date would effect the use of these materials in an emergency.

  • Are you a M.D. or D.O.?

  • I am happy to answer that, but first I am curious why you want to know and why the distinction would matter. I have great respect for all physicians I work with on daily basis, both MD & DO.

  • you said that we need to start in the middle of the wound and then stitch one side first. how do u move back to the middle from one end to start the stitch of the other side??

  • 05endless - Great question . . . and one I can only answer in a video update. Stand by and I will try to do that today with a "5endless" shout out!

  • Could tweezers be used to apply sutures in an emergency?

  • No . . . you need something similar to a hemostat which is why I demonstrated the Leatherman Squirt P4 . . . the ideal substitute since it has a narrow nose spring loaded plier that is hopefully ALWAYS with you. If you don't have a P$ than I would get a small fly fishing type hemostat. I just don't like extra gear or weight and my P4 is reliably always with me.

  • Ok, I have hemostats to. What's the best type to use for suturing? There's Mosquito, Kelly, etc.

  • Excellent video. I happen to know for a fact that you can't push a sewing needle through human flesh with your bare hands when you have to. I was once kicked in the side of my leg buy a horse that apparently had a horse shoe nail sticking way out of the shoe. He cut me good. I was alone and required serious help. I had some fishing line and two fish hooks. It worked. Not a nice job, and left a scar, but it saved my ass that day. We all know how easy it is to get a fish hook into human flesh.

  • Interesting. Thanks!

  • Thank you for sharing your video. Please keep them coming.

  • excellent videos, keep up the good work

  • please do more of this stuff!!!!

  • Well done!

    On the next goose I shoot, I think I'll make a cut in the breast through the skin (after plucking) and give it a try.

  • Very clear. Thanks.

  • Excellent,very well done,straight to the point hope to see more vids like this in the near future Good luck

  • I would like to see a vid on stabilizing a gunshot wound if you are in an area where it will take a while to get to an ER. I know there are 1,000 diff possibilities but maybe a generalized wound to the torso. I have no idea what to do other than direct pressure. Just a suggestion. Good Day !! Ms. Shannon

  • Great info!! I practiced today but my pig seems to be walking funny now :) Actually I helped my friend yrs ago when she was in school learning this stuff. LOL She saw it in class, I read the book and looked at pictures and I was better at it than she was at first.(we are both dyslexic learning knots)LOL She became a cosmetic/reconstructive surgeon while I am a loly forensic shrink. LOL I assume she got better. It's not hard but does take practice. Thx for the review, great vid!! Ms. Shannon

  • Excellent video and very informative. I have carried sutures for many years in my first aid, but thankfully never needed them. I HAVE however used steri strips and super glue many many times with great success (very little to no scarring with glue)

    I must say I do carry peroxide but only use for SURFACE cleansing.

    Thank you for your great efforts, and excellent instruction.

    OCTOS....out

  • Ocrtos -

    Thanks for all the comments and support!

    I have some videos planned showing best use of glue and field expedient steri-strips / butterfly closures.

    Glad you haven't needed sutures yet!

  • Your welcome sir.

    I am a subscriber, and as a former EMT I am ALWAYS the one who patches up my buddies on hiking and mountain biking trips! I look forward to future videos on these subjects, and whatever else you choose.

    OCTOS....out

  • USNERDOC Thank you very much for this great video series. Very informative. I personally would love to see more videos from you with this type of subject matter (first aid in the field). I would assume from your username that this type of work is your profession. Either way, you obviously know what you are talking about. Thanks again!

  • tabre -

    Many thanks for the kind comments. I was quite surprised by the reception this series received. Lots of comments, questions, emails and PM's. I plan on producing more of the same. This is an area of particular interest for me. You have my YT user name figured out correctly!

  • I have done this so many times with prior training evolutions and I have to say you aren't the first to ask that question! ;-)

  • Fantastic video! The hard work you put into this really shows, thank you so much. I am going to order some sutures right now so I can start practicing. Hopefully I will never need this skill, but better to know and not need....than to need and not know. Enjoy your holiday and I look forward to your review of your first aid kit.

  • Cool! I would love to know how the practice works out.

  • looking forward to your review of the first aid kit you put together.

  • Wow, very cool video, and thanks so much for taking the time to make the PDF available as well!

    5 stars and subbed!

  • edthetallguy - Many thanks!

  • one of the most informative and useful videos (that I hope I will never have to use). Great information for someone like myself that right now can't afford to take classes.

    thank you.

  • Thank you very much!

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