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Old 03-27-2014, 01:14 PM   #11
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Spot on, brother. Anything deeper than what can be taken care of with the benzoin and steri-strips, or superglue, should raise the question of seeking advanced medical care, or if it should be closed at all. Some wounds are better off being left open, and then packed, with daily dressing changes until they close from the bottom of the wound all the way back to the surface. Usually it's a process of weeks, but less likely to get infected or leave bacteria harboring pockets under the surface of a closed wound.
Short of post-op closures or reattachment I was always of the opinion that there were only two valid reasons for suturing. The first was cosmetic. The second was taking wound care responsibilities away from the patient.

I lived in a county where pulp wooding was the main industry. Over the years I have seen some horrible complications resulting from home suturing including loss of limb and death. If you can't get the pros from Dover, clean it, dress it, if possible elevate it, and let it close on it's own. You may end up with a nasty scar, but chances are you'll live to show it off.

A quick question. Have you ever used honey to debride a wound? Avulsions and burns are the primary uses, but it works great on bedsores, too.
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Old 03-27-2014, 01:47 PM   #12
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I have not used honey but had seen it used by a surgeon when I was on a deployment in Haiti back in the 90s, on burns, along with antibiotic ointment.
that surgeon also taught me of using sugar mixed with Betadine as a wound packing for stubborn, slow healing, post surgical wounds. There was a patient who had surgical excision of a pilonidal cyst who had been coming in daily for wet to dry dressing changes for a month. The wound just kind if hit a point where it wasn't progressing anymore. The surgeon would take sugar and mix in Betadine until the combination reached a consistency of wet sand. He'd pack it into the wound and cover it with sterile gauze. The patient would come in the next day and the mixture would have melted and mostly absorbed into the gauze, working still like a wet to dry dressing. But the tissue granulation rate was increased a lot and the wound seemed really clean. We would repeat the application. After a week and a half no packing was required.

The surgeon explained that he had seen the same mixture used on horses with stubborn ulcers near the feet, that had problems healing because they were always wet and dirty. He said the iodine provided protection against the bacteria, the sugar also was bacteriostatic in such high concentration, and the crystal structure of the sugar granular acted as a catalyst and framework to encourage tissue growth.

I ended up using the same mixture on a crew member during a submarine deployment, who also had a post surgical wound that was refusing to heal.

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Old 03-27-2014, 01:58 PM   #13
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Underway, I used the stapler and Dermabond (just expensive superglue) for most of the lacerations that guys would get from the sharp edges that seemed to appear out of nowhere.

Anytime a crew member got hurt and needed my help, I would brief the Captain. One deployment we had guys get hurt three days in a row during drills. The first one was a scalp laceration from a overhead bracket. I briefed the CO that the crew member was doing well and that I had used 5 staples and everything looked good. The next two were a facial laceration and a lac on the shoulder, but were fairly small and stable so I briefed the CO that I had glued them. The CO asked "Doc, don't Corpsmen do stitches any more?" I explained my reasoning and advances in technology and the fact that even the submarine force was advancing in medical care. He got to watch me do stitches a week later when one of the officers had a slip with a knife, while cutting zip-ties. He cut the back of his hand and had cut some facia and had exposed one if his extensor tendon sheaths, but thankfully had not cut the tendon. That one I had to close in layers. So I invited the CO to watch so he could rest assured that I still knew how to sew.

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Old 03-27-2014, 02:02 PM   #14
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Originally Posted by SSGN_Doc View Post
I have not used honey but had seen it used by a surgeon when I was on a deployment in Haiti back in the 90s, on burns, along with antibiotic ointment.
that surgeon also taught me of using sugar mixed with Betadine as a wound packing for stubborn, slow healing, post surgical wounds. There was a patient who had surgical excision of a pilonidal cyst who had been coming in daily for wet to dry dressing changes for a month. The wound just kind if hit a point where it wasn't progressing anymore. The surgeon would take sugar and mix in Betadine until the combination reached a consistency of wet sand. He'd pack it into the wound and cover it with sterile gauze. The patient would come in the next day and the mixture would have melted and mostly absorbed into the gauze, working still like a wet to dry dressing. But the tissue granulation rate was increased a lot and the wound seemed really clean. We would repeat the application. After a week and a half no packing was required.

The surgeon explained that he had seen the same mixture used on horses with stubborn ulcers near the feet, that had problems healing because they were always wet and dirty. He said the iodine provided protection against the bacteria, the sugar also was bacteriostatic in such high concentration, and the crystal structure of the sugar granular acted as a catalyst and framework to encourage tissue growth.

I ended up using the same mixture on a crew member during a submarine deployment, who also had a post surgical wound that was refusing to heal.
That is a really good tip, especially if you find yourself in a less than stellar environment. Thanks for the info. The actions appear to be the same as the honey, but with honey the iodine would thin it out too much.
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Old 03-27-2014, 04:17 PM   #15
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A lot of good info, my sister is a nurse and has worked trauma and we have a dr. Friend who will be joining our bugout group.
I also have ob kits I don't plan on having a baby but we never know what can happen in a bugout situation or how long it will last. As a prepper I am trying to aquire everything we would need for long term off the grid living that is the idea of the thread is to get more ideas for a fully stocked first aid/emergency kit. Thanks for the ideas so far a lot of stuff I did not know.

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Old 03-30-2014, 06:23 AM   #16
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Keep it up guys this is great information!

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Old 03-30-2014, 06:52 AM   #17
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Keep it coming. I like putting a first aid kit in every car and when I wear my winter coat I have one in an inside pocket.


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Old 03-30-2014, 07:33 AM   #18
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I have an expensive Bag with just about everything except an operating table. Ran me about $400 about five yrs ago. More recently, as well as extra consumables, and smaller indiv. Kits for each member of our MAG...


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Old 04-06-2014, 04:27 AM   #19
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Quote:
Originally Posted by SSGN_Doc View Post
Spot on, brother. Anything deeper than what can be taken care of with the benzoin and steri-strips, or superglue, should raise the question of seeking advanced medical care, or if it should be closed at all. Some wounds are better off being left open, and then packed, with daily dressing changes until they close from the bottom of the wound all the way back to the surface. Usually it's a process of weeks, but less likely to get infected or leave bacteria harboring pockets under the surface of a closed wound.
For those with no experience, one way to practice is get a side of pork (most like human) or beef, or any large part that still contains the outside skin, fat and muscle, and put MINOR cuts in the outside flesh to start. You'll be surprised how hard it is to hold together and stitch with only two hands when you first start. But overall, unless excessive bleeding is a problem, stitching in first aid situations is usually a bad idea. Any wound deep enough to need stitching also needs antibiotics more often than not. If the patient bleeds excessively and packing the wound doesn't work, then stitches may be needed as a life-saving measure. Quik-Clot or the correct super glue will usually suffice in this situation.

Quote:
Originally Posted by SSGN_Doc View Post
I have not used honey but had seen it used by a surgeon when I was on a deployment in Haiti back in the 90s, on burns, along with antibiotic ointment.
that surgeon also taught me of using sugar mixed with Betadine as a wound packing for stubborn, slow healing, post surgical wounds. There was a patient who had surgical excision of a pilonidal cyst who had been coming in daily for wet to dry dressing changes for a month. The wound just kind if hit a point where it wasn't progressing anymore. The surgeon would take sugar and mix in Betadine until the combination reached a consistency of wet sand. He'd pack it into the wound and cover it with sterile gauze. The patient would come in the next day and the mixture would have melted and mostly absorbed into the gauze, working still like a wet to dry dressing. But the tissue granulation rate was increased a lot and the wound seemed really clean. We would repeat the application. After a week and a half no packing was required.

The surgeon explained that he had seen the same mixture used on horses with stubborn ulcers near the feet, that had problems healing because they were always wet and dirty. He said the iodine provided protection against the bacteria, the sugar also was bacteriostatic in such high concentration, and the crystal structure of the sugar granular acted as a catalyst and framework to encourage tissue growth.

I ended up using the same mixture on a crew member during a submarine deployment, who also had a post surgical wound that was refusing to heal.
The other reason sugar/honey solutions work is the increased osmotic pressure they create. The cells touched by the solution tends to release fluid into the mixture and die off, thereby killing infected cells and increasing healing. This does have to be changed every day and should be done with a wet to dry dressing.

Medical crazy glue, i.e. Dermabond, is formulated differently than the crazy glue you buy at the grocery store. The common crazy glue contains fuming acids and other chemicals that can cause allergies, skin irritations and toxicity. If you are going to use it for wounds, get Dermabond and don't endanger your patient.

From Wiki(emphasis mine):

Some rock climbers use cyanoacrylate to repair damage to the skin on their fingertips.[9][10] Similarly, stringed-instrument players can form protective finger caps (in addition to calluses) with cyanoacrylates.

CA glue was in veterinary use for mending bone, hide, and tortoise shell by the early 1970s or before. Harry Coover said in 1966 that a CA spray was used in the Vietnam war to retard bleeding in wounded soldiers until they could be brought to a hospital. Butyl cyanoacrylate has been used medically since the 1970s. In the US, due to its potential to irritate the skin, the U.S. Food and Drug Administration did not approve its use as a medical adhesive until 1998 with Dermabond.[11] Research has demonstrated the use of cyanoacrylate in wound closure as being safer and more functional than traditional suturing (stitches).[12] The adhesive has demonstrated superior performance in the time required to close a wound, incidence of infection (suture canals through the skin's epidermal, dermal, and subcutaneous fat layers introduce extra routes of contamination),[12] and final cosmetic appearance.[13][14]

While standard "superglue" is 100% ethyl cyanoacrylate, many custom formulations (e.g.,, 91% ECA, 9% poly(methyl methacrylate), <0.5% hydroquinone, and a small amount of organic sulfonic acid[15] and variations on the compound N-butyl-cyanoacrylate's for medical applications[12]) have come to be used for specific applications.
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Old 04-07-2014, 04:14 AM   #20
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I got cut on a off shore supply boat. I didn't want to go in to an ER, so I stitched myself up with monofilament. You can still see the scars where I stitched up the wound, no scars from the wound itself.

I keep vetwrap from the feed store in my first aid kit. Vetwrap is less expensive, comes in many different colors and it does a better job of repelling water. If I couldn't get to an ER vet wrap and gauze are what I want.

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