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#65747 - 05/16/06 04:06 AM Re: What's the best size suture for a PSK FAK
ironraven Offline
Cranky Geek
Carpal Tunnel

Registered: 09/08/05
Posts: 4642
Loc: Vermont
Really? Then how come it has been used with success by every culture going back to the Babylonians? If it made the wounds sour, there would have a lot more of them that didn't use it. In particular, the Romans used it, and they had the best medical system in the West until the mid-1800s.

Oh, and why is it still taught by military medical schools the world over? Maybe not to Navy corpsmen who would generally be on a vessel, but I KNOW that it's being taught to CSAR personnel and to people who might be a bit out of touch for a while. Flotsam, they told you about this, I'm willing to bet. It's isn't supposed to be your first choice, but it's far from the worst.

Water is a "very, very good medium" for bacteria, to. So is saline. Urine is basically warm saline with trace amounts of minerals, unless there is something wrong inside of you. Chemically, it's rather like sea water, only with less salt (usually, depends on your diet), a trace of ammonia (which kills things) and no microbes (unless you have an infection). Sure, if you leave a pocket of it in the wound, you're in trouble, but you have that with any irrigation fluid. Everything get's dirty once it's out of the bottle, and unless it will kill tissue, it will have bacteria growing in it 24 hours later. That's unavoidable in real world conditions. All you can do is minimize it.

Although, most people also spaz at the idea of using large ants as sutures. Show me a BIG honkin', tropical ant hill, and I'll show you more skin staples than you'll ever need. The folicle of a horse's tail strand is supposed to be sharp enough to stitch with (Chris, can you confirm?). Leach and maggot therapy makes most peoples skin crawl, and those are coming back to, in "convential" medicine. We aren't talking about something where you can be on a bunk in the ED in an hour. This is when something has gone very wrong. Given my choices, I'll irrigate with fresh water or saline. But giving a choice between leaving crud in a wound, and making someone a little queezy when I drop trou, guess what I'm picking?


Edited by ironraven (05/16/06 04:14 AM)
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When a man dare not speak without malice for fear of giving insult, that is when truth starts to die. Truth is the truest freedom.

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#65748 - 05/16/06 04:10 AM Re: What's the best size suture for a PSK FAK
ironraven Offline
Cranky Geek
Carpal Tunnel

Registered: 09/08/05
Posts: 4642
Loc: Vermont
Yeah, looking over my first post, I wasn't very clear on it. Sorry if I sounded like I was taking your head off- I've been told I'm doing that a lot lately, without meaning to.

Something about four days of torrential rain and arthritis. Makes everyone crabby.
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-IronRaven

When a man dare not speak without malice for fear of giving insult, that is when truth starts to die. Truth is the truest freedom.

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#65749 - 05/16/06 04:44 AM Re: What's the best size suture for a PSK FAK
desertrat1 Offline
Member

Registered: 02/16/06
Posts: 144
Loc: Kingman AZ
No Problem, I can understand, except here in Arizona it's the number of days over 110 degrees that set you off.
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#65750 - 05/16/06 04:47 AM The weather is a pain
ironraven Offline
Cranky Geek
Carpal Tunnel

Registered: 09/08/05
Posts: 4642
Loc: Vermont
I'd be looking for people with axe is hand. I don't mean the skunkspray they sell to teenagers. :P

At least with the rain, you have to be tied up have me outgimp you on a day like this.
_________________________
-IronRaven

When a man dare not speak without malice for fear of giving insult, that is when truth starts to die. Truth is the truest freedom.

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#65751 - 05/17/06 03:59 AM Re: What's the best size suture for a PSK FAK
Trusbx Offline
addict

Registered: 01/16/02
Posts: 397
Loc: Ed's Country
Urine in the bladder is sterile to a certain extent, but once it comes out of the bladder, it passes thru the urethra and picks up the microorganisms therein and innoculates the wound with the said bacteria.
Primitive cultures had no concept of microorganisms and sterility hence they should be forgiven for treating wounds as such.
But like you said, if the choice was to have crud in the wound and nothing else, I would choose blood. Let the wound bleed to clear out the crud, then stop the bleeding. It would certainly be better than pissing on it.... <img src="/images/graemlins/blush.gif" alt="" /> But of course, if you really have no other choice, with no other irrigation fluids available, this would be better than dirt.....

In terms of preference:
Sterile saline
Non sterile saline
Sterile water
Non sterile water
Clean water
Blood
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#65752 - 05/17/06 04:21 AM Re: What's the best size suture for a PSK FAK
ironraven Offline
Cranky Geek
Carpal Tunnel

Registered: 09/08/05
Posts: 4642
Loc: Vermont
No arguement, blood is a good flush. You just need a lot of it.

The funny thing is, this is identical to a conversation I had with a buddy of mine a few years ago, but with the roles reversed. His background, he's a USAF PJ. I argueed the points on contamination with bacteria, pretty much the same about picking up cells during passage that Trus has made, he sent me about three pounds of documentation to back up it's use, both current and historical.

Emergency treatment, yes, but a valid one with relatively little side issues, is the summary.

And that is my last words on this sub-thread.
_________________________
-IronRaven

When a man dare not speak without malice for fear of giving insult, that is when truth starts to die. Truth is the truest freedom.

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#65753 - 05/17/06 08:27 PM Re: What's the best size suture for a PSK FAK
billym Offline
Addict

Registered: 12/01/05
Posts: 616
Loc: Oakland, California
Irrigating with a diluted PI solution (10%) is proper proceedure when the water is not sterile. This is current proceedure according to the Wilderness Medical Society.

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