Information on suture materials and suturing as well as other options for closing wounds was posted in the early years of the blog. Links are posted below for these articles.
Skin staplers, glues, and tapes all serve just as well as sutures in most situations dealing with superficial wounds. In some, they’re even better, especially if you can avoid using precious anesthetics and inflicting further pain. And there will be less scarring.
Unfortunately, none of those materials will work if it is subcutaneous layers of tissue that need to be sutured. There is no way to use staples, tape, or glue deep in the body and then close the wound. All those materials would cause massive discomfort and infection. Fortunately, those types of injuries are not so common, but when they do arise, we need to have options.
I’ve got a couple dozen sutures here, many of which can be used subcutaneously or deeper, but what if those run out, or if they were damaged in a disaster? What then?
I knew I had an answer here somewhere, that I’d read about it, but I couldn’t find the sources in all my references. I was pretty certain the answer lay in Survival and Austere Medicine, 3rd Edition, but try as I might, I couldn’t find it. I’d flip page by page, and then get distracted and move on to another topic. It was only when one of the authors notified me of an error that I was able to find the information I’d been curious about for so long.
So when it comes to alternative suture needles for underlying tissues, the authors of Survival and Austere Medicine, 3rd Edition, offer a couple of suggestions.
1. Small sail makers’, glove makers’, or upholsterers’ needles. They’re already curved into shape.
2. A straight sewing needle heated in a flame until red hot and then bent into a curve.
3. A swaged needle (suture needle that has the suture thread clamped onto it) can be made from a hypodermic needle by passing the suture material through the needle. It is scored and broken at the hub. Then the end is crimped, thus securing the suture to the needle. Sterilization can occur when the suture is made and then used immediately, or the sutures can be made in advance, sterilized and stored until needed. The SAM3E authors suggest an 18 gauge needle and fishing line inserted and crimped into place. Then use pliers (and presumably heat) to bend the needle into a curved shape.[i]
Obviously, your best bet is to have plenty of sutures that can be used subcutaneously. Veterinary grade sutures can be purchased through ShopMedVet.com, Amazon, and other places. Feed and ranch stores are a great place to pick up medical supplies as well.
Links to related posts:
Skin Staplers: Do You Want Them in Your Medical Kit?
Where to Purchase Medical Supplies
[i] Survival and Austere Medicine, 3rd Edition, 2017, 267-68.
Please don't do the red-hot bend the sewing needle trick for a suture needle. The metallurgy of a common sewing needle is not even close to what serious curved needles are FORGED to deal with.
ReplyDeleteThe forces involved inside a deep enough wound you would close has snapped makeshift needles inside.
I know because a recent case we were digging out the fragments of that needle, surgery wearing lead aprons and lots of fluoroscope radiation.
Jennifer, remember when were discussing looking ahead? A little history of what wilderness traders sold might give an idea what matters when things get less civilized. A set of real forged sewing needles is cheaper than a burger and fries at a drive through. Pack a lunch or two and BUY them. Large spools of stout poly thread are far cheaper per meter of actual length than Walmart spools.
Excellent trade items later. Home repairs of belts, clothing, repairing mattresses and such spring to mind.
Michael,
DeleteThank you very much for your comments and experience.
Personally, I far prefer to store the actual item rather than the work-arounds. I'd rather store lots of flour than grow zucchini and spend precious time and energy dehydrating and powdering it to use as a flour substitute. I'd rather store lots of soap than the supplies to make soap, or worse, rendering the tallow and turning wood ash into lye, and then making the soap. I'd rather store lots of suture needles than turn sewing needles into suture needles.
But most people don't think like that. They need suggestions for workarounds, and it's better if those workarounds come from legitimate sources, which I consider SAM3E to be. Whether the solution works for them is their issue, and I get to keep my flour, soap, and sutures.
I tend to agree Jennifer but breaking a home made needle in the wound is insult to injury. Cannot find it in the bloody wound, and an additional hazard to the healing process. Thus my concern.
DeleteMichael