How to suture a wound?

How to suture a wound?

Going on camping and staying in a cabin with family and friends is a great experience for sure. The wilderness in which the cabin is situated is far off from civilization. There is tranquility, serenity and solitude all around the place. The quiet and pristine ambience is something that is not found in normal urban life. The experience is absolutely unique and different.

Accidents and mishaps can take place anywhere. Just imagine that while camping, your friend is splitting and chopping wood. The axe or the maul which he uses for the chopping slips accidentally and instead of hitting the log, cuts deep into his legs. The result is a deep and large gash on the leg. However, luckily the maul or the axe did not injure any artery or vein in the leg, so there is no risk of immense bleeding, which could lead to an emergency situation. Though the wound is deep and large, there is no need for shifting him to some hospital or for other medical assistance immediately. Though there will be bleeding initially, it will gradually stop as per the body’s natural law. Give him support and bring him back into the cabin. Sit patiently and take a deep look at the wound or the gash. The first thing that needs to be done is to clean the wound.

While coming for camping, you must have brought some first aid kit with antiseptic solution and cotton. Use these two ingredients and clean the wound thoroughly. The bleeding will have stopped by then, but there will be a gaping wound on the leg of the injured person. It is important that the wound is closed up so that there are minimal chances of infections taking place at the spot. Closing the wound will also accelerate the process of healing. You might think that a butterfly bandage might work in this situation, but it will not keep the wound together. It is becoming quite obvious that the wound will need to be stitched up. But finding a doctor at such a place is nearly impossible. Also, it will take quite a few hours to reach the city or town and get a doctor for the stitches to be done.

However, if you have a suture kit as a part of first aid supplies, you can sew up the wound on your own and provide relief to your buddy.


What is meant by suturing?

Many people hesitate in saying stitches when it comes to wound healing. For them suturing is an acceptable term. When a sterilized needle and thread is used for sewing a severe wound, it is known as suturing. When this is done, the tissues start healing quickly and properly. Most importantly, since the wound gets closed, the chances of infections are minimized in the process.

Generally, sutures are used when the wound is gaping and quite deep. There is an excellent example to illustrate this fact. When there is a deep wound, the fat tissues are visible if you look closely. In such cases, you will surely need stitches. Using a bandage for closing the wound could be an idea. But this would not bring the desired results. Only the top part of the tissue will be joined with a bandage. The tissues beneath the skin will remain separated and will not join. This will only be possible when stitches are done on the gaping wound. If the tissues under the skin have gaps in them, they will become a ground for infections. With suturing, you can be ensured that all tissue layers are brought together and there are no gaps whatsoever. The wound and the damaged skin starts healing quickly with the help of suturing.

Suturing might also be needed in other conditions. Here is an example of the same. A person got involved in an accident severely so much so that a finger got detached from his hand. The accident took place in an extremely remote area and there was no access to any kind of emergency medical room immediately. The victim’s father was a veterinary doctor and he used his suturing kit for sewing the detached finger back to the hand. It is quite obvious that the sewing was not perfect. But the sewing proved to be very effective as the tissues in the detached finger did not die. They shifted the boy to some emergency medical room and proper suturing was done on the finger. The victim still has that finger and can use the same.


DIY suturing is only recommended for times of real emergencies

If you thought that stitching wounds is as simple as stitching torn clothes, you are highly mistaken. There is a lot of difference in both the processes. For suturing, you will need to learn the skills and that takes quite a lot of practice. If suturing is not done in the correct manner, it can cause life-threatening infection. The wound also does not heal properly and causes further complications. If you can suture perfectly, you might just leave an ugly looking scar on the skin of the person.

When suturing is done in proper manner in a medical setup, some kind of numbing agent is injected into the area where the suturing will be done. When the needle perforates the skin while sewing, the pain is not felt due to the anesthesia applied. However, when suturing is done in some remote place, having the numbing agent is next to impossible. So obviously, the process of suturing will be extremely painful. This is another valid reason that suturing should be done in times of real emergencies only.

For the above mentioned reasons, suturing should be done only in times of real emergencies, when a doctor will not be available within 12-24 hours. In case there is a deep gaping wound, try stopping the bleeding by any way. Try closing up the wound by using gauze or butterfly bandages. The next step should be finding an emergency medical room and going there immediately.


Suturing supplies needed if you need to do suturing in case of an actual emergency

In extreme conditions, you might need to use some regular old needle and thread. These should be sterilized with boiling water or by some other means for suturing the wound. Using such things is difficult as the needle and the thread would be hard and secondly the chances of infections from using such stuff will be high.

For effective and proper suturing of a wound, a suturing kit is needed. Mentioned below are some of the things that are commonly needed:

  • Tissue forceps – While applying the suture, this appliance is needed for adjusting the tissues around the wound.
  • Needle driver – With the help of the driver, the needle is held when one is putting it through the tissue.
  • Sterilized needle and thread – While applying stitches on someone, foreign objects are being left inside their body. Thus, it is important that they are sterilized. Buy sterilized suture threads as they are readily available in medical survival stores. These medical needles are typically curved so that the sewing process becomes easier.
  • Scissors – This is an important tool, which is used for snapping off the extra thread.

All these tools should be properly sterilized as these will be used directly on human skin. Sterilizing alcohol wipes are a good choice in this regard.


How to suture a wound?

If you thought that suturing is a uniform process and is applied on all kinds of wounds, you are wrong. There are different techniques of suturing and the extent of difficulty varies from one another. If you want to minimize scarring impact on the skin, more complicated and complex suturing techniques are implemented.

In this article, there is demonstration of performing intermittent or interrupted sutures, which is the simplest and most straightforward suturing technique. The suture is called interrupted as the stitches are not connected to one another. One stitch is made, it is tied off and then another stitch is made.

Interrupted stitches are secure and simple to place on the skin. When compared to continuous suture, changes to these stitches can be made more easily. Just one stitch needs to be cut, the wound can be adjusted and then a new stitch can be done again.

Mentioned below is guided step for carrying out interrupted sutures:

  1. Wash your hands thoroughly with soap and water so that there are minimal chances of infecting the wound. The wound has to be prepared for suturing. Use water for cleaning the wound. If there is blood, clean the same by using clean cotton and antiseptic lotion. Put on latex gloves so that the hand is not in direct touch with the wound.


  1. You must use the needle driver for grabbing the needle properly. The needle clamp should lock in the right place. All the thread should be pulled out of the suture kit.


  1. Take the tissue forceps and use it for exposing the side of the wound where you will begin stitching. This will help you in seeing what you are working with and the actual depth of the wound that needs suturing. It is recommended to line up the wound edge as much as possible.


  1. At about 90-degree angle, push the needle through the skin. The thread should come about a centimeter to the other side of the wound. See that the thread or the needle does not go below the fat layer in the tissues. It should slide right above it.


  1. When you have reached deep enough, twist your hand in clockwise order so that the tip of the needle comes out on the other side of the wound. The needle should come out straight from the first needle hole.


  1. When the needle comes out from the other side of the wound, the needle driver should be unlocked and reattached near the needle tip. It has to be pulled until there is about 1-2 inches of thread on the right side of the wound. After this, the needle needs to be released.


  1. Use the left hand and hold the thread on the left side itself of the needle. Wrap the thread twice around the needle holder’s tip.


  1. Open the needle holder slightly. The 1-2 inches of thread which is there on the right side of the wound needs to be grabbed.


  1. Pull the thread’s long part with your left hand. You will see that the thread which is wrapped around the needle holder will slide off. Basically, this is nothing but creating an overhand knot with double loops. This is known as ‘first throw’.


  1. The thread has to be tightened in such a manner that the tissues touch one another. Moreover, the knot on the skin should be lying in a flat manner.


  1. The process that starts now is referred to as ‘second throw’. Use your left hand and take the long end of the thread and hold it tight. Wrap the thread once in clockwise manner around the needle driver. Open the needle driver slightly and grab the thread’s short end. Use your left hand and pull the long part of the thread. The surgeon’s knot is done with another overhand knot.


  1. The above-mentioned step has to be repeated one more time and this is referred to as ‘third throw’. This actually helps in creating a highly secured knot. Instead of wrapping the thread around the needle driver in a clockwise manner, wrap the same in anti-clockwise manner. The knot will not be slipping by any means.


  1. Take the scissor and cut off any excess thread that is there.


  1. Now it is time for the second suture. Just go quarter of an inch below the wound and repeat the whole process mentioned above.


  1. Be careful about one thing. All the knots should be done on one side of the wound. If you tie the knot on the right side of one stitch, let all the knots be on the right side only and vice versa.


  1. Once the stitching work is complete, sutured wound should be wrapped using a sterilized bandage.

This is a temporary solution to the problem. You must seek professional medical assistance at the earliest so that no further complications take place.