Hi all,

What you use at home (in car) for an emergency wound closure/suture kit. I'm looking at the several offered by Adventure medical and wonder if there's another tested/true supplier.

Much appreciated.

Do you have the necessary knowledge and training to know when and how to utilize the kit? Closing wounds improperly can lead to severe infections. Wound care outside the hospital/ED environment should center on bleeding control and proper wound cleaning. Unless one is in a very remote area and failure to properly clean and close the wound will endanger your ability to survive/function, I would leave home/field wound closure alone.

Pete

Agree - for wounds that may require suturing, pressure to stop or reduce bleeding, sterile dressing, drive to a doctor. In an emergency or when you are far from medical help, steristrips work just fine for smaller wounds - in fact I can recommend the wound closure kit from WMI as a very cost effective ($4) prep for such situations. Usual disclaimers: make sure your first aid training matches up with the care you intend to apply; and I get no benefit from WMI or any vendor, just a happy camper.

http://www.nols.edu/store/product.php?productid=16259&cat=256&bestseller

Thanks to all for the feedback.
I agree, would only use suture in the event that Doctor/ER is unavailable and situation warrants it. I've been in some extreme situations I defer common sense and think through things before acting.

I ordered both the the suture kit and wound closure kit. The wound closure kits appear to be one step above the standard butterfly bandaid-very nice...

I agree 100%. Don't do it!

I don't know if you carry these in your regular FAK, but in light of my recent experience (http://forums.equipped.org/ubbthreads.php?ubb=showflat&Number=208790&gonew=1#UNREAD)
I would suggest adding a couple of trauma pads, a roll of gauze, and a roll of waterproof/stretchy tape to your wound care kit.

Also, if you're anything like me, adding a chemical cold pack to counter the adrenaline surge to your wound care kit makes patching yourself up easier.

Thanks for the comment but it's quite obvious that it shouldn't be done improperly.

The original query is based on there being no trained paramedic/emergency rooms available within a reasonable amount of time and needing to close a serious wound.

FYI I've attended medic first aid training (Scuba rescue diver cert), us army general first aid, worked in a hospital (5 blocks from WTC during 9-11), so I do have some knowledge/experience and would refer to applicable literature if the need arose.

Thanks again

Instant (Un-Flavored) Mashed Potatoes to stop the Bleeding,Duct tape torn in thin strips to semi'close the wound,Kotex-Maxipad or Israeli Bandage if pressure is needed.This does work in a pinch!I am not a Medic,Nor am I a Physician,tech,or even an Amateur!This is something that worked for me,& I'm here to tell about it! YMMV

I apologize in advance for the long and probably confusing reply but I tend to ramble on. I hope some of the information is helpful to people.

As a surgical assistant I routinely help close surgical wounds with suture, staples, steri-strips and skin glue. From working closely with surgeons I have an understanding of wound healing issues such as infection and scarring. I also have several years of experience as an EMT I/II and W-EMT.

Closure of a wound is considered to be identifying and attaching together the wound edges for the full thickness and length of the wound.

Packing and dressing (bandaging and dressing) a wound is considered to be using things like gauze sponges (the packing/bandage) in/on the wound and covering them with something like tape or self adhesive wrap (the dressing)

Some things to consider about closing a wound in the field:

Is the wound more than skin deep, is there a possibility that underlying structures such as nerves, blood vessels, tendons etc. involved? Is the bleeding uncontrolled? If any of these are the case, wound closure in the field is a waste of time and could hinder proper medical treatment. Temporary or partial closure, or packing and dressing the wound and transporting the patient to higher medical care might be more appropriate. Deep wounds, i.e. more than full skin thickness should not, and probably can not, be closed in the field.

If the wound is not deep with nothing that requires repair and no uncontrolled bleeding, is the would clean? Was the injury caused by an uncontaminated object to a clean area? If not, do you have the resources to thoroughly clean the wound with lots of water, preferably sterile, and disinfectant? Closing a dirty wound will significantly increase the risk of infection.

If the injury is superficial but more than a simple scrape or nick and field closure is appropriate then what is the goal off the field wound closure? Better wound healing, limiting annoying but trivial bleeding and reducing the risk of infection. Tools that might be used are things like suture, staples, steri-strips and skin glue.

Suture: Requires a cooperative patient, technical proficiency, instruments (needle driver, forceps, scissors), suture (e.g. 3-0/5-0 mono-filament, nonabsorbable), preferably a local anesthetic (e.g. Lidocaine) and a very clean work area. Suture is slow to apply but generally easy to remove and provides good closure to any wound location.

Staples: Requires a skin stapler (and typically a forceps) and a cooperative patient. Staples are relatively quick but not painless and work almost anywhere on the body, but are not typically used on the hands or face. Staples are generally easy to remove and provide a good closure. An additional dressing is typically used.

Steri-strips/butter fly closures: Quick, easy to apply, can be used almost anywhere on the body, and are often used with benzoin or mastisol to aid adhesion. Steri-strips are usually covered with a dressing. Steri-strips can be very difficult and painful to remove. This is particularly important to consider if the closure is only being considered as a temporary measure.

Skin Glue: Medical grade cyanoacrylate (e.g. Dermabond, Indermil) This is a quick, relatively safe and easy to use method of sticking skin edges together. Its likely everyone on the board here has a crazy glue story. This is my preferred method of wound closure at home and in the field. It works anywhere on the body, is easy to use and doesn't require additional dressing.

Excellent responses here, and I'm watching with interest.

Most mesh with what I've been told, i.e., clean the wound if possible, pack it off tightly while maintaining limb circulation, and don't make things worse than they already are.

I'm not an expert, but I assume that the introduction of any non-sterile material into a deep wound is an extremely bad idea.