#143312 - 08/08/08 08:08 PM
Anyone used the Stapler?
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Icon of Sin
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Registered: 12/31/07
Posts: 512
Loc: Nebraska
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#143324 - 08/08/08 09:23 PM
Re: Anyone used the Stapler?
[Re: Nishnabotna]
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day hiker
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Registered: 02/15/07
Posts: 590
Loc: ventura county, ca
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in the ad they show an "arrow" wound, nicely stapled shut, on an unknown, unnamed part of someone's anatomy.
unless it were "only a flesh wound" - can an arrow wound only be a flesh wound? - i would hesitate to close ANY puncture wound unless irrigated with a lot more water than what you typically have to spare out in the woods.
and if you do carry such a thing what are chances the wound would be in a location that you could staple shut yourself? which now begs the question: if not you, who? trust them, do you?
for me, i'll stick with tincture of benzoin and steristrips. with a nice 4 x 4 + gauze wrap to protect, keep clean and absorb any further drainage.
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#143327 - 08/08/08 09:44 PM
Re: Anyone used the Stapler?
[Re: bsmith]
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Addict
Registered: 07/18/07
Posts: 665
Loc: Northwest Florida
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for me, i'll stick with tincture of benzoin and steristrips. with a nice 4 x 4 + gauze wrap to protect, keep clean and absorb any further drainage. Yeah. Me, too. Now, for my canine hiking buddy, where he have a hard time leaving steristrips and bandage alone, maybe. But he's gonna have to carry it in his pack. Jeff PS Are there really a lotta folks out there getting shot with arrows?
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#143340 - 08/08/08 11:03 PM
Re: Anyone used the Stapler?
[Re: Jeff_M]
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Cranky Geek
Carpal Tunnel
Registered: 09/08/05
Posts: 4642
Loc: Vermont
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Not a lot of people getting shot, but a lot of bow hunters having clumsy moment and sticking or slicing themselves.
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#143344 - 08/08/08 11:08 PM
Re: Anyone used the Stapler?
[Re: ironraven]
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Addict
Registered: 07/18/07
Posts: 665
Loc: Northwest Florida
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Not a lot of people getting shot, but a lot of bow hunters having clumsy moment and sticking or slicing themselves. Oh, I hadn't thought of that. Doh! I've seen a large number of people get shot with guns, but never one with an arrow, even though bow-hunting is popular 'round heah. Jeff
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#143346 - 08/08/08 11:15 PM
Re: Anyone used the Stapler?
[Re: Nishnabotna]
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Geezer
Registered: 09/30/01
Posts: 5695
Loc: Former AFB in CA, recouping fr...
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I have been stapled a few times, but was sound asleep when the dr did it. I suspect that a staple would hurt a lot less than a stitch, done in the boonies. But I am not a big fan of closing a serious wound until it has been properly cleaned. Properly, not just washed out a little bit...
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#143349 - 08/08/08 11:27 PM
Re: Anyone used the Stapler?
[Re: OldBaldGuy]
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Addict
Registered: 07/18/07
Posts: 665
Loc: Northwest Florida
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But I am not a big fan of closing a serious wound until it has been properly cleaned. Properly, not just washed out a little bit... Nothing like closing in an infection, hmmm? I've seen that a few times, ugh! Like a lot of tools, staplers are fairly easy to use, but knowing when and when not to use them is the real trick. Jeff
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#143357 - 08/08/08 11:49 PM
Re: Anyone used the Stapler?
[Re: Blast]
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Old Hand
Registered: 11/09/06
Posts: 870
Loc: wellington, fl
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Widely used in ER's, mostly for scalp wounds cuz the scars are substantially larger than a good suture job-or on hockey players faces, where aesthetics are of no consequence. Simple, fool-proof, but not idiot resistant, still, if you scew up, you just take the staple out and try again...15 times. Surgeons practice suturing lacerations on raw chicken parts, so you could get 2 and practice. Closing the wound helps it heal faster, but the bleeding has to be controlled before wound closure-the anti-coagulated guy who wrote the product review may be disappointed when he tries it. Some docs will close a wound that is eight hours old, some won't, so if the ER is a few hours away, might be okay to wait.If the wound is closed over an infection, an abscess develops As noted above, best not to close arrow wounds, animal bites, or other punctures. Note: do not attempt to remove skin staples with a standard office staple remover-the results are way worse than the original injury. Before there were disposable skin staplers, there were hog rings These were used in similar applications on swine, wire cages, upholstery. The swine probably didn't like it, but swine are hard to read. Hog rings also played an important part in repairing prolapsed uterus in cattle, but we will save that story for another time.
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#143362 - 08/09/08 12:38 AM
Re: Anyone used the Stapler?
[Re: nursemike]
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Youth of the Nation
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Registered: 09/02/07
Posts: 603
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I would be scared if someone showed up if i was hurt with that in their hand!!!
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http://jacesadventures.blogspot.com/ - - - - - - - - - - - - - - - - - - - - impossible is just the beginning though i seek perfection, i wear my scars with pride Have you seen the arrow?
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#143366 - 08/09/08 01:12 AM
Re: Anyone used the Stapler?
[Re: Nishnabotna]
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Wanderer
Member
Registered: 09/02/06
Posts: 119
Loc: Southeastern USA
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I have assisted ED docs when wounds were closed with the stapler, but none without the Lidocaine local having been administered. I can't imagine attempting to staple or suture a wound without some form of anesthetic being given, OUCH!!, especially on a child. Any thoughts?
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#143369 - 08/09/08 01:31 AM
Re: Anyone used the Stapler?
[Re: rescueguru]
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Addict
Registered: 07/18/07
Posts: 665
Loc: Northwest Florida
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I have assisted ED docs when wounds were closed with the stapler, but none without the Lidocaine local having been administered. I can't imagine attempting to staple or suture a wound without some form of anesthetic being given, OUCH!!, especially on a child. Any thoughts? One thought: You're right. It's likely to hurt like Hades. I was also wondering about it being for sale without an Rx. I'm too lazy right now to do it right now, but any of our expert folks feel like writing a detailed post on exactly how to clean and dress various types of wounds "in the field," including using steri-strips for closure, if needed, for the benefit of the group, or maybe just dig up a good link? Jeff
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#143388 - 08/09/08 04:00 AM
Re: Anyone used the Stapler?
[Re: CANOEDOGS]
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Member
Registered: 01/25/04
Posts: 160
Loc: Mid-Missouri
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I've used these in the ER and OR. It is easy to use, good closure BUT. This is wound closure, not recommended in the field. The wound needs to be meticulously cleaned first. It would hurt like Hades to use this without local anesthetic ( lidocaine). If you believe that girls like scars, you'll love this - prominent scar guaranteed each use. I keep some around to patch up pets and livestock, I use suture on the humans, usually after taking them to the ER, so I've got the stuff to do it right the first time. This would be good if you're way off the grid. or maybe combat situations, or if you really like scars.
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#143429 - 08/09/08 06:46 PM
Re: Anyone used the Stapler?
[Re: marduk]
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Enthusiast
Registered: 08/23/05
Posts: 289
Loc: WI, MA, and NYC
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+1 on that.
Anyone using this in the field on a wound that hasn't been properly cleansed is risking a nasty infection and the misery that goes with it. Selling this to the general public? I wonder what kind of legal disclaimers it comes with...
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#143430 - 08/09/08 07:05 PM
Re: Anyone used the Stapler?
[Re: marduk]
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Geezer
Registered: 09/30/01
Posts: 5695
Loc: Former AFB in CA, recouping fr...
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"...prominent scar guaranteed each use..."
Indeed they are. My stapled zippers are much neater looking than the sutured ones...
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#143432 - 08/09/08 08:04 PM
Re: Anyone used the Stapler?
[Re: OldBaldGuy]
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Pooh-Bah
Registered: 03/08/07
Posts: 2208
Loc: Beer&Cheese country
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All right, someone asked for an official "how-to."
Scalp wounds in the ER don't usually get lidocaine. Why? Well, you use a needle to put in the lidocaine... so you're being stuck anyway. Just stick them with the staple and be done with it. Yeah, I hear it hurts. People tend to jump. Clean the wound copiously with clean water (some people use a little betadine swirled in, YMMV). Pull the edges together so that the parts match up (kind of like matching up puzzle pieces - the indent in the skin on one side matches to the extra skin on the other) Staple it closed. The middle of the stapler is the centerline for the staple.
For non-scalp wounds, we usually take tweezers, grab the skin, and actually evert it, so that when the staple is in place, the skin "falls" back into alighnment, with just a touch of the edge still rolled up (I hope this is making sense). Leaves less of a scar, and it's a 2-person job.
Probably OK to use in the field, provided: A) you irrigate the heck out of the wound, and there's no visible debris. At least 1/2 liter. More if it's bigger. B) You staple far apart, about 1cm between staples. This allows the skin to still be open between the stitches, allowing a route for pus and stuff to egress. Of course, you can also pull the staples and re=clean the wound if you really need to. But at that point, you can't re-staple it closed.
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#143436 - 08/09/08 08:47 PM
Re: Anyone used the Stapler?
[Re: MDinana]
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Old Hand
Registered: 11/09/06
Posts: 870
Loc: wellington, fl
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All right, someone asked for an official "how-to."
Scalp wounds in the ER don't usually get lidocaine. Why? Well, you use a needle to put in the lidocaine... so you're being stuck anyway. Just stick them with the staple and be done with it. Yeah, I hear it hurts. People tend to jump. Clean the wound copiously with clean water (some people use a little betadine swirled in, YMMV). Pull the edges together so that the parts match up (kind of like matching up puzzle pieces - the indent in the skin on one side matches to the extra skin on the other) Staple it closed. The middle of the stapler is the centerline for the staple.
For non-scalp wounds, we usually take tweezers, grab the skin, and actually evert it, so that when the staple is in place, the skin "falls" back into alighnment, with just a touch of the edge still rolled up (I hope this is making sense). Leaves less of a scar, and it's a 2-person job.
Probably OK to use in the field, provided: A) you irrigate the heck out of the wound, and there's no visible debris. At least 1/2 liter. More if it's bigger. B) You staple far apart, about 1cm between staples. This allows the skin to still be open between the stitches, allowing a route for pus and stuff to egress. Of course, you can also pull the staples and re=clean the wound if you really need to. But at that point, you can't re-staple it closed. Hockey players don't get lido, wherever the lac is-lidocaine burns on injection, and we occasionally use hypodermic needle bigger than the suture needle. or it may be that the scar tissue of previous wounds is numb anyway. MDinana's guide reflects state of teh art practice as I have seen it-nice job, MD-
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Dance like you have never been hurt, work like no one is watching,love like you don't need the money.
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#143671 - 08/11/08 03:44 PM
Re: Anyone used the Stapler?
[Re: nursemike]
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Geezer
Registered: 01/21/04
Posts: 5163
Loc: W. WA
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Why would anyone be so anxious to close a wound that they would buy one of these, much less use it?
Ignorance + a new toy = Darwin Award.
Don't you visualize your buddy considering this a new toy to play with? ("Okay, Joe, I've got the first twenty-five in. Need anything else stapled? Joe? Joe?")
I don't want people who watch doctor shows on TV and think they've learning something doing anything fancy on me.
Clean it, wrap it, go to a doctor. Period.
And that goes for my dog, too.
Sue
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