# Suture kits?



## Hoghunterdiva (Jun 25, 2013)

Where is the best place to order a decent Suture kit? I lack that in my med kit.


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## Grimm (Sep 5, 2012)

It all depends on what you mean by "kit". You can get everything but the actual sutures at a local medical supply store. The sutures can be found on vet medical supply websites, ebay, feed stores or ask your vet.

I got a great deal on several boxes of silk sutures from our vet. They were going to toss them since they have an expiration date on them and I offered to "cover" their disposal fee. 

If you can't find "real" sutures a spool of silk thread and some good sharp sterile needles will do. Just a heads up, REAL silk thread is expensive so opt for a dark color like black and the spool with the most yardage. Rather have too much than find your self in need of more. The dark color since stitches and wounds weep and who wants to see icky colored stitches.

You can find one time use surgical staplers too if sewing yourself up makes you dizzy.

K opted for the stapler and steri-strips since he is a wuss about pain. Plus he thinks I'm a bit stitch-happy.


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## jnrdesertrats (Jul 3, 2010)

Try amazon.They have some assorted kits that are expired and good for "training"
They also have staplers and steri strips. I posted about this about a year ago and some know it all kept trying to convince everyone we are not qualified. In spite of me trying to convince him it would be as a last resort. If he is still around let him be right it is really important to him.


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## Caribou (Aug 18, 2012)

I watched a guy stitch himself up once with a needle and thread. You can do it but you really will prefer a suture.


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## 8thDayStranger (Jan 30, 2013)

I stitched up my hand with fishing line once. Bad cut on a camping/drinking trip. Everyone was too drunk to drive so I filed the barb off a small hook and did it myself. The doctor I went to a couple days later was not impressed. The nurse was though.


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## backlash (Nov 11, 2008)

I have a couple dozen.
If you want a couple PM me and I'll drop some in the mail.
Offer open to everyone until I run out.


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## Grimm (Sep 5, 2012)

http://www.ebay.com/itm/Adventure-M...167?pt=LH_DefaultDomain_0&hash=item4173f98b27


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## OldCootHillbilly (Jul 9, 2010)

Here be a perty decent site fer a fair amount a med stuffs. I ain't gonna say they be the best, but there prices seem perty darn good.

http://www.shopmedvet.com/category/suture-and-skin-closure

Get expired stuff an practice on a nanner. It'll get ya there.


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## jadedsoul (Feb 15, 2012)

I have more than once used super glue to close things up in a bad situation. My ex was a dr and she said its not much different than using stitches. Now I have 6 small tubes in my first aid kit and BoB just for that purpose. But on the other hand i did super glue my glasses to my hand one time too.


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## drfacefixer (Mar 8, 2013)

jadedsoul said:


> I have more than once used super glue to close things up in a bad situation. My ex was a dr and she said its not much different than using stitches. Now I have 6 small tubes in my first aid kit and BoB just for that purpose. But on the other hand i did super glue my glasses to my hand one time too.


Problem with this is that cyanoacrylate isn't just cyanoacrylate. For years the only medical grade cyanoacrylate was n butyl and it sucked. It had toxicity problems and did a so so job at closure (low shear strength) and I give it a c- acting as a microbial barrier. Tissues were also prone to irritation and inflammation resulting in ugly scars. Octyl-cyanoacrylate is light years better. Stronger, less toxic, and much less reactive. Spend the money and go with dermabond. I've used it routinely to close port entries for laparoscopic surgeries among many other closures. The trick is you have to have an almost absolute dry field.


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## Jim1590 (Jul 11, 2012)

Not sure if I was the guy complained about above, don't think so though, I was only a jerk about IV's as far as I recall. Feel free to correct me here, I have gotten to the point of putting the info out there and with my caveats, letting you do whatever you want. But I will always push the training!!! lol

The thing you need to do with sutures is to know what size needle and thread to use where. Also what layers to sew together! Sure a simple surface lac is straight forward, but you need to know what to do with the deep ones. Wouldn't be good to stitch a tendon to a ligament. Myself personally would probably look more at the staples. The dermabond is probably better.

Just the other week while camping with the family, our 7 month old grabbed a soda can and sliced his inner bend of the thumb open on the spout. A quick call to grandma (whos camper we were using) led me to the dermabond in the first aid kit (she is a retired RN). Worked great since we couldn't exactly reason with him that we needed to apply pressure! The problem is that since she is retired, we gotta pay the huge amount to replace it. Think it is about $25 per dose.


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## drfacefixer (Mar 8, 2013)

Dermabond is about $22-25 per carpule and available on amazon. You can get it without a license as long as you aren't buying bulk discount from a medical supply store. It does work well. Its great on hand, elbows, wrists - areas where a suture would pull through without undermining the tissue significantly. I'm sure that's above most peoples comfort or knowledge level here anyway. Even at my quickest, it would take me a good 10 - 20 minutes to block, get hemostasis, and close a decent laceration on a hand or foot. Dermabond will do this in about 5 minutes after you wash/clean and get bleeding stopped. Do remember though that even if you can take care of the cut, you may not be out of the woods. Any significant deep /puncture would is cause to consider giving a tetanus booster.

As for sutures, unless your a trained medical professional anything other than plain gut or prolene is going to be a waste of time or money. You can potentially use silk although, it wicks bacteria and has a higher infection rate, as well as reacts with skin = scarring (but its good in the mouth!). If you feel comfortable closing multiple tissue layers and know of the complications - then I'm not here to stop you. But for most, its never going to happen and its an expensive "what if" to prepare for. There are a hundred other questions you would get to before you got to stitching this to that. If you're looking at ligaments and possible tendons, then your into some serious need of much more medical equipment. You would likely be in need of stocking anesthetic, minimum of 10 hemostats of multiple sizes, antibiotics, electrocautery, multiple packs of gauze, liters of sterile saline, multiple retractors, skin rakes, and finally your various suture materials. 

I do this on a daily basis and try to be as minimalistic as possible. The fact of the matter is that if I can get the person comfortable, thoroughly clean the areas, explore for debris and get bleeding stopped - seeing the multiple layer and putting like back with like isn't as hard as you would think. If its not a complicated laceration involving multiple layers, then cracking open $20 worth of dermabond is cheap. Sutures usually costs me about $6 for plain gut, $15 for prolene. The price is extremely dependent on the needle type and sizing of the filament.


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## Jim1590 (Jul 11, 2012)

And antibiotics might be in order. If you happened to have used any sprays or ointments on the wound before trying a dermabond, make sure to wipe it off so the skin is fully exposed.

drfacefixer, thoughts on this stuff? http://www.amazon.com/health-personal-care/dp/B000GCICQ6

Ingredients are benzethonium chloride 0.2%, dyclonine hydrochloride 0.75%, acetone, amyl acetate, castor oil, drometrizole, ethyl acetate, nitrocellulose, SD alcohol 40-b


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## drfacefixer (Mar 8, 2013)

JimMadsen said:


> And antibiotics might be in order. If you happened to have used any sprays or ointments on the wound before trying a dermabond, make sure to wipe it off so the skin is fully exposed.
> 
> drfacefixer, thoughts on this stuff? http://www.amazon.com/health-personal-care/dp/B000GCICQ6
> 
> Ingredients are benzethonium chloride 0.2%, dyclonine hydrochloride 0.75%, acetone, amyl acetate, castor oil, drometrizole, ethyl acetate, nitrocellulose, SD alcohol 40-b


I like it for small cuts and scrapes. Its much thinner than dermabond, but it tends to also peel up after 24-48 hours. For small cuts that might be all you need. I wouldn't use it you try and reapproximate any tissues you need closed or you're in fear of reopening. It tends to do just that.

I mainly use this stuff on my kids cuts, scrapes (and my own) before they get into a bath or shower. The skin breaks tend to sting without it and they never seem to mind once its on. It does sting a lot going on because it's an alcohol polymer mix and the adhesive laysdown once the alcohol or organic carrier evaporates. There are various brands which have different "active "ingredients but the adhesives are similar. 3m makes one with a tea tree oil, others use astringents. For larger scrapes, I'll let some lidocaine jelly sit on the scrape for a few minutes before painting it. That takes the sting away.

If I think the cuts going to bleed and possible reopen I'll just dry it well and go with dermabond. If I think having the dermabond stick around for 7 days is going to lead to the desire to peel it off early, I'll go with the liquid bandage.

There is a new rival to dermabond called liquiband that's new to the market. Its another 8 octylcyanoacrylate that is marketed as a patient applied product. It might bring down the cost of dermabond or completely undercut it. we'll have to wait and see.


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## mojo4 (Feb 19, 2012)

OK doc, what is your best advise for someone whose medical knowledge starts and stops at peroxide and bandaids. Dermabond? Or what type of suture kits should I look for? I don't have anyone in my group with any nurse or paramedic experience so it has to be ******* proof and beavis and butthead simple.


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## mojo4 (Feb 19, 2012)

Well apparently from my prior post jacka$$ is on the naughty word list!


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## helicopter5472 (Feb 25, 2013)

A tube of superglue, a quart of Jack Daniels, your good to go....Come on Cowboy up....


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## Jim1590 (Jul 11, 2012)

Here is the dermabond:

http://www.amazon.com/Dermabond-Top...UTF8&qid=1373127850&sr=8-2&keywords=dermabond

You use it for surface cuts (don't see much fatty tissue, ligaments or tendons (white rubberband looking things) muscle (your steak dinner) or bone) when you can easily bring the skin together and bleeding stops momentarily with direct pressure.

Clean and dry the area and break the dermabond capsule. It has a glass inner tube inside the plastic outer tube. This releases the glue. Hold white tip down and gently squeeze. After a min or so the white type is now purple. Wipe clean the cut again and then "paint" the cut with the now purple tip while giving it a little squeeze. Think of it like painting with a q-tip. Cover the entire area. Let dry for maybe 30 seconds and then apply another layer. Keep going until tube is empty. Make sure you get enough good skin all the way around so the dermabond has something to grip.

Don't practice with it, it is expensive, instead practice with the skin shield above, same concept.


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