Wound Closure in the Field
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- เผยแพร่เมื่อ 16 ก.ย. 2024
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This is really an old nursing technique called Montgomery Straps. This used to be standard nursing education 30 years ago. We used them primarily on open abdominal wounds. Tape on each side, double folded at the edges like that. Then safety pins at the edges and rubber bands across to pull everything together and hold the bandage in place. Allows you to easily remove and replace the bandage and cleanse the wound. Probably wouldn’t find any nurses nowadays that know how to do it unless they are old timers like me. LOL.
You are correct, sir. I never saw them when I worked in the hospital or heard of Montgomery Straps before but that is damn sure what this is like
TH-cam comments are a gold mine of info
@@motionsick when the contents are valuable, smart and knowledgeable people arrive 😜
So basically you're stitching the duct tape instead of the skin. That's ingenious really. I've seen and read quite a bit about first-aid and had never heard of or even considered this technique. That's awesome. Thanks for the video. 👍
Correct, stitching the duct tape instead of the skin.
@@GrayBeardedGreenBeret how are you going to get a good clean patch to get the adhesive to get on there? I keep stari strips on hand. The concept makes sense but large wounds get wet from blood typically.
@@GrayBeardedGreenBeret PSA Staples are available.
@@wannabecarguy This is under the presumption that you have controlled the bleeding. As he said in the video, paramedics do not stitch together wounds in the field. They make sure that the bleeding stops, with a tourniquet for example. Once you stop the bleeding - you're 'safe' - for the time being. This gives you time to clean & and properly treat the wound, as shown in the video.
Great principle but you are still introducing contaminates to the wound using tape, furthermore the wound would approximate by inversion opposite of what you want and would no doubt cause MARSI if it did manage to adhere to the skin . A simple wound dressings with compression would suffice because there will be a delayed primary closure anyway. As for steri strips they are a dressing for subcutaneous sutures and typically you need something to stick the steri strips on top of Mastisol is commonly used for this. Steri strips would not stick to anything that is moist nor does it have the tinsel strength of suture, hence it can only be used for small lacerations that are superficial with low tension. The face and brow are common areas steri strips (called butterfly stitches). I was in the Army as a 11B, 91B, 91C, 91D served in all combat arms units down range. In the civilian sector I am a surgical first assist and hold these certifications SA-C, OPA-C, NREMT-P, T, W and Surgical first assist instructor, EMT wilderness instructor and surgical technologist instructor. I love seeing how people really over think these situations when just having the basic supplies on hand such as a CAT, Israeli bandages, and packing gauze all sterile is all you need along with a good medical foam tape. PSA these items are real cheap to buy. These duct tapes are just plain bad for wound care. they do not have water resistance, breatheability, initial adhesion to dry skin.
For those that missed the point: This is for self-care and bush-care! Example: I filleted my hand open 10 yrs ago with a 4” open wound and used a similar method to close the wound, except I used tape over tape rather than stitch. It was difficult to perform on myself but very effective. Never got stitches and only have a small scar as a reminder.
Your method would have been more effective; however, you had not yet released the video!😂. Thank you for the training.
Many years ago, my 10 y.o. son cut his head open at a campground in the Dakota badlands, about 100 mi to the nearest ER. After thoroughly cleaning the wound and (finally) getting the bleeding stopped, I twisted together 3 or 4 hairs that I teased out of his scalp on either side of the cut line as 'sutures.' I pulled them together and used a makeshift surgeon's knot to approximate and close the wound edges. There was zero bleeding afterward, and this was a rather deep cut that definitely needed stitches, about 4 inches long. Fortunately it was a 'clean' wound (no dirt or grit or tree branches involved) and was straight with no jagged or torn edges (this was way before the days of using super glue). I applied a generous amount of neosporin on it, kept an eye on it and just let it heal on it's own afterward, and in about a week, the hair 'sutures' grew out and all that remained was a very light scar. As it was well above the hair line, I wasn't concerned with any cosmetic results. The only problem was that my son was upset that I wouldn't let him go swimming for 7 days! I was a flight nurse at that time, and learned this trick from one of the old-school ER docs I worked with. I hope I have described this procedure well enough to be used by someone else. Keep up the good work!
This is a great technique for scalp lacerations. Nicely done.
Great technique,I will remember this one
Could’ve used that a few weeks ago with my daughter lol! We were in the black hills so not as far as the badlands, but about 3 miles deep on a hike. The staples she ended up getting at urgent care was shotty work at best. They were more worried about covid than helping.
@@thebeloved1327 i guess better have some Staples than covid 👍
I keep some curved needles with eyelets in my kit. Horse hair ( from their tail) will work if you are 3 days ride from help.
Student Doctor here. This is EXACTLY what we are taught.
Hopefully you guys are getting better supplies than duct tape and bank line, though! 😂
@@GrayBeardedGreenBeret Yes, but the principle still applies obviously. Dermabond can be utilized on fragile tissue to get the same effect you're getting with that duct tape (of course sterile suture let's you use the skin directly in addition).
@@cm2973 absolutely; Dermabond is the bees knees
I am usually alone when in field conditions....Have first aid kits, just wanted to know of any self-reliant prepping that could accomplish similar wound care goals by myself, in your opinion? Thank you
@@MrNacash thats not what was said.
Just wanted to make sure you knew that the reason I like this video so much isn't just your background, nor merely great advice. The reason is how well you explain, elaborate, and give reason for the things you're teaching and advising, very nicely done sir, and Thank you, from a lifelong learner.
This video was in my feed a few weeks ago. A strong instinct told me to watch it. This is a genius method to close wounds and very well taught. I filed the info away for future use. This morning, at 3:30 am, my 26 yr old son came to me with a cut across his lower right calf about 4" long. For a couple of reasons, he was terrified going to the ER or clinic. I remembered your video and knew what to do. Once bleeding stopped, I started. Holy cow, duct tape is hard to push a needle through! It took an hour, but it worked wonderfully. Thank you from the bottom of my heart.
check leukotape out, has better holding on skin even in wet conditions, you can easily replicate this or make butterfly sutures big or small for the area.
How high was your son?
@@benm5913 : Fair question. He wasn't high, he was drunk. He has severe social phobia, extreme anxiety, and PTSD on top of Ehlers Danlos Syndrome. He cuts to relieve the pain. A manipulative, cruel person he once trusted told him that cutters are involuntarily committed if they see a doctor. The blade was very sharp, his hand slipped and he tried to staunch the wound, but couldn't.
@Bruno Mieter : That's harsh. Thankfully, not here. It had been a year and a half since he last cut. It really scared him, so hopefully it will be last.
@@verniceaure4865 prayers for your son that he may get the healing he needs.
Only found this guy today and can't stop going to the next video ..the best I've every found after countless years of looking ..well done sire ..
I jumped! Lol. 100% Respect for that calm, focus and not taking the bait.
Channel NEEDS at LEAST 1 mil subs
using cordage/string reinforced tape to take the sutures is brilliant on many levels. there are adhesive tapes designed to work on wet surfaces for #1. you do this stuff after you've applied pressure and are changing the dressing and notice that bleeding has been sufficiently stopped/reduced that you can risk more bloodloss while closing the wound so there is little chance that you will have a wet/damp adhesive surface to worry over. #2 you are not puncturing the skin additionally in the field in a non-sterile environment with thread that may not be sterile to begin with let alone be sterile the first time the wind blows. #3 no risk of sutures tearing free.
As the helicopter SAR doctors (all being anaesthetic specialists, aka life support) told us on our annual training since the 1980s - if you can not short-time contain a situation with duct-tape the problem may not be end perfectly.
Now, that was (a bit) tongue in cheek (but mentally useful).
I never saw your double-slit sowing method before. That was awesome! A really great way to provide maximal distal circulation alive. (We just "steristripped" with duct-tape and secured it with the "double-slit" on top).
I will have to say - if one entered an ER here in Norway with THIS handiwork attached, I am pretty sure all doctors and nurses would be called in to take a look at this handiwork and give a good old Kudos before they even bothered to clean one up professionally. Thanks for teaching me something new and reminding me that while I am an old dog I can still pick up a fantastic new trick every so rarely.
I also like the duct tape steri-strip method, sometimes that is all that is needed.
Amazing! You are completely right I was licensed and trained as an EMT and we are not taught to suture we are taught to irrigate using saline solution and to apply pressure with gauze and dressings and to use tourniquets proximal groin and proximal axillary. We never suture this can have a negative outcome leave that to the doctors in the ER in an outdoor situation you want to prioritize stopping bleeding and infection prevention. This is how you know you're getting good quality training in this video great job!
Irrigation is probably the most important step and also the one most people forget during first aid.
Everyone…his Wilderness Medicine 4 disc DVD set is phenomenal! If you’ve taken a stop the bleed course & first aid course, this builds on those two & give great improvisational techniques that can same a life. Thanks, Josh! 🥾🏔
…& save a life. 🙃
Good technic, love it! (former military medic and civil EMT)
Very good advice, thanks for sharing. 6:20, had such a good giggle because that's exactly what I would have done.
Never thought of this technique and i'm a trauma paramedic in remote settings, this will go in my book of improvisations good sir ;)
Emergency and family medicine MD. I self-thought intradermic suturing and regularly use it in my daily practice. It’s doable both with nylon, vicryl and catgut thread: It’s the best way not only to minimise scarring, but also effectively cut on bleeding. Works great on most lesions. The kind of looking suture you did above on the tape is usually used to close torn up mucosa in a narrow canal (as in vaginal tearing up during natural childbirth).
I am not a medical professional. I am often in remote areas, whether backpacking, hunting, canoing, fishing... Currently, I take 3 or 4 feminine maxi pads (plus 2 tampons) and a couple yards of duct tape. The pads are sterile and absorbant and can be changed out easily. They're good for burns or blisters, too and it a very light kit. For no additional weight, I have learned another way to deal with possible injury. Thank you for posting this.
BTW, The tampons are to stuff in critic's mouths..... (actually, they can be tinder, wound filler, help clean up a spill or water in a tent...)
Outstanding.
Love the Animal House reference.
Sir you are correct about suturing in the field. Working in military & civilian ERs, as well as serving with the Marines in the field (Navy Corpsman) since 1979, you will only close in dirt, which will lead to infection. You can always cut out the scar tissue later, make nice clean edges & suture it back together when you are in a clean environment.
I was was Light infantry back in late 80's and always said we should have silencers and better medical training thanks for sharing I like your teaching professionalism Thanks
A clean sock with the bottom cut off works good to help hold this on and protect from dirt and dust. Still breathable for healing.
Now this is the kind of stuff they need to teach everyone... great info can't wait to learn more .
Solid content. I prefer using duct tape fashioned into " steri strips ", they can be supported by perpendicular strips of tape depending on circumstances. As you state, hemorrhage control and cleaning the wound is far more important.
As for the suture kit, I recommend carrying antiseptic/ antibiotic ointment and packing gauze instead.
Thanks for sharing the skills and knowledge you spent years acquiring, most folks have no idea how much time and effort goes into learning what you have learned.
there are a few other versions taught in the actual film, this is just one way
Clove oil can be used an anesthetic and will prohibit bacteria growth. Just a word of caution.. it burns for about two minutes then you're pretty darn numb. I always leave a drain or small hole. If the wound is pretty darn bad, might be time for a CAT at that point. Good stuff, and a great way to teach surgeon knots.
I was in Iraqi Freedom and always had a roll of duct tape with me and it saved my life twice once on a HMMWV Radiator House that got me out of a tough spot in Umm Qasr, Iraq. The repair lasted 3?weeks! Another on an injury but I did not use the same technique as my brother soldier in video. I really learned something here!
I am an x- US Army medic, Your instruction is spot on Exellent. thanx
Not only Is this a usefull skill to have In the field, but It looks awesome!
I just found your videos.
Your advice blows the rest of them out of the water.
Back in the 50's when I was a youngster and getting into scrapes I had few nasty cuts on my legs. My old man, having used tweasers to get grit out of the wounds used a clean toothbrush while pouring a diluted mixture of Detol (antiseptic bleach) and hot water to clean out the wound. He then used zinc oxide tape to close it over and match each side of the open wound. A wee bandage and off in 3 days, keep an eye on it. Never did I get an infection and I was left with fine white lines. I did damage the noggin occasonaly and that was a hospital job. He couldn't get out of the habit that Dr.'s cost money and yet he now had an National Health Service free at the point of need. This crackin' technique is not just for the bush it should be in everyone's locker. McIntyre. Best Wishes from Scotland.
Thank you for showing another useful way of using tape in a very important survival way. Never would have though to do this.
Thank you for the video and keep on pushing them out. Love it.
Forbidden "just rip it off quick!!" Bandaid removal 👌
Best advice and free education I’ve seen onTH-cam so far.
As a former Military member with all the Combat Life Savers courses I've been through, this is probably one of the coolest tricks I've ever seen. Probably not preferred in a fire fight, but definitely for afterwards. Thanks for spreading the knowledge. I'm going to try this on myself to see how easy it would be one handed.
That is genius wound closure. Thanks.
Thanks for the very practical information. Love the duct tape and stay suture technique. As a veterinarian I see all kinds of wounds from superficial to fatal. You are right on when you say suturing a wound closed is not the same as hemostasis (stop bleeding). Arteries bleed just fine under a closed incision and the bleeding does more damage. If you are able to ligate serious bleeders that's best but it requires help, suction, good lighting, instruments, etc. By the way, I am always amazed at how thick human skin is...much thicker than dog, cat or even horse.
A couple of anecdotes:
Had a shin injury while cutting brush for a hide. The wound was shallow. The cut went through my BDU's, through the skin, through the membrane over the bone (Doc Speece called it a coelom), and made a very shallow cut in the surface of the tibia, maybe 1/16th or 1/8th inch. I didn't think much of it. Put on a pressure bandage and continued mission. Not many nerves there. This was maybe 1996 or 95.
Firstly, the pressure bandage didn't do much. Boot filled with blood, which was inconvenient and made me worry about foot injuries due to soaking the foot before a long walk out. I noticed when changing bandages that the very narrow and clean cut pulled open laterally by about an inch. So, what was initially a cut like a closed eye-lid later opened like an eye. Doc was adamant it had to be sutured immediately. He did the sutures in a...well... lets just call it a 'less-than-clean' environment, though he did irrigate and used an iodine brush.
Thoughts?
With respect to suturing in the field?
It turned out fine. No infection. And now hard to find the scar (unsurprising given how shallow it was).
Second vignette, had another superficial cut (about 1/4" deep and 2-3" long) on forearm from concertina. It was through the top layers of skin but I am not sure if it went through the fat layer. I thought so, because I was curious what the muscle looked like and looked as best I could at it given its location. I remembered the less-than ideal situation with the pressure bandage. So I tore the gauze from the bandage and sealed it with duct tape. I didn't sew the duct tape in two strips, like you did in the video. I just pulled it before sticking it to the far side so it pulled the sides together. I didn't have the chance to get any medical attention for several days or a week afterward. Honestly don't remember how long. This was all in the field, with a long walk of a couple dozen miles to get to a pick up point. All I did was maintain hygiene (bar soap, washcloth, clean water) and change the gauze and tape once a day and dab a little neosporin or similar from a little tear-packet on it before reapplying.
This made a bigger scar.
But...the skin where the duct tape was developed open sores. It didn't seem to be from removing the bandage. It seemed more like a reaction to the glue on the tape over time. The cut didn't get infected. The lesions did. But I was Mission Complete before it became an issue.
Thoughts about the tape technique in light of this?
What about the insertion of gauze over the wound under the tape? Good? Bad?
When you fold over the gaffer tape over the bank line or para cord...leave a bit of a "lip" along the entire fold over sections. This would make the tugging on the two sections of tape much easier. You then have a built in handle to pull the two edges closer together while sewing...making the process cleaner and less painful, your fingers being further away from the wound and the whole stitching process will go that much quicker.
Edit:- I'll add this from other commenters:- a roll of gauze soaked in alchohol (or whatever you have) placed on or in the wound...then stitched up using this technique. The doctors at the emergency room will be quite impressed.
Remember, all you armchair warriors out there...a simple compression bandage will do if an ambulance is on it's way. This technique is for field wounds where first aid might be the only medical treatment for hours.
There is a definate difference between first aid in the bush and first aid at home with a cell phone in hand.
Gear Repair is EXACTLY why I carry medical sutures in my kit !
This is pure genius. Amazing, fantastic. Thanks.
Great job ,well thought out . Straight forward. A lot of people try to over do. I am not a Dr have some skills learned in the Army. Just need to last till I name it back or am picked up.
I’m stealing this! I’ve been teaching emergency medicine for more than a decade to military doctors, PA’s, NP’s, Nurses, but mostly combat medics and first responders. There are a few more considerations that I’d add to a class that includes this technique but otherwise this is a dang awesome procedure to be able use when you need it... and there’s no NSN to look up to put on the packing list!
Take it and pass it on
Great information. Learned more in 10 mins then I have in a 2 day course in the military.
Fully agree with this. A lot of people fail to remember that when you’re in the field, you aren’t in a sterile environment. That means you can’t sterilize your wound prior to closing. Closing a bacteria infested wound will cause you more problems than bleeding will, and that’s for sure.
Carry a airplane sized bottle of vodka in your kit.
I needed stitches a few days ago after cutting myself with a broken glass while washing the dishes.
I IMMEDIATELY kept the DEEP wound close, cleaned it and before it could start bleeding again, I just poured copious amount of superglue over it. I had antibiotics laying around and I also took them. Bleeding continued for a while and blood got mixed with the glue, also because I just couldn't wait for the bleeding to stop, but it has polymerized in a few seconds.
I often use this technique and I'm getting really good at it. For small cuts, 4 to 5 stitches long, it's awesome.
If you have enough time, the best is to use a piece of clean absorbing paper as a guide for the glue. Just apply it on the cut and pour the glue. It will absorb the blood that comes out when you leave the pressure and it gives you a cleaner result.
STAY SAFE AS MUCH AS YOU CAN AND DO NOT PANIC !! (consider it bold not yelling)
What an awesome techniqe, will file this away in my head and hope I never have too use it! I've stitched myself up before with a sewing needle and fishing gut and don't ever want to go though that again!
I snuck out to the lake with my buddies when my parents were at a wedding and I was supposed to be at home studying for finals. Got kneed in the face playing football and bit the inside of my lip right open from one side to the other. When I got home I was more scared of being caught than the pain, so I disinfected everything with peroxide and put 11 stitches in. Used a bent needle, fishing forceps and 7X tippet material. Discovered that skin is really tough! Had to keep rethreading the needle to push it through from the inside. And tying each stich off individually. got it done in front of the bathroom mirror and just finished and cleaned everything up just before my parents got home. Used boiled herbal tea bag poultices for a couple of days after to draw out infection and control swelling. And no I wasn't caught lol.
To this day I can't tell you why I didn't just say I tripped down the stairs and bit my lip and let them take me to hospital when they got home???
Former scrub tech here. THIS. IS. BRILLIANT! I love all of your videos & content; this one is especially close to my heart. Fantastic!!
Seems like a gentle and intelligent man. I wouldn't get on his bad side though. Keep up the great vids sir!
I appreciate the info here, but also recognize exceptions. 90% of my medical care is self care and that has included sewing up my own wounds (stitches if one prefers that term). I have had hospital stitches and staples as well in my life and the biggest difference: I TAKE THE TIME TO DO IT VERY WELL. In all of my hospital cases, the "professionals" have Not.
I realize that they are rushed and overloaded with demands, but that doesn't mean I'm ok with the horrible avoidable scars that they left me with - the places that I sewed up myself have zero visible evidence of scaring. The healing was just as clean and infection free as I would have gotten from a hospital.
Now here's the thing - I do long hiking: weeks at a time between visits to towns for food resupply and I do this for months on end. I cannot rely on medical support - there is no 911 in the wilderness. Yes there are rescue options for life-threatening situations, usually involving a lack of personal mobility, but a lot of things happen that fall short of life-threatening, and field medicine doesn't require hyper specialization. A keen degree of uncommon common sense, superior intelligence and a healthy dose of experience along with a few key supplies can go a long way.
I will, however state that watching TH-cams does Not count as experience, and I fear that some folks just don't quite get that.
Consider carrying a small sealed bag of white sugar, super glue, bandage rolls and duct tape. In field casualty temporary repair -To treat a wound with sugar, all you do, is pour the sugar on the wound and apply a gauze bandage on top with duct taped edges. At 1st redressing pull the wound together apply super glue to edge and hold until it stays and redress. The granules soak up any moisture that allows bacteria to thrive. Without the bacteria, the wound heals more quickly. Make sure the duct tape dose not close off air to the wound.
I'm grateful for your videos! My grandfather was 10th SF in Bad Tolz under Aaron Banks. Thank you.
So instead of suturing kits, there should be ready-made tape kits where you just need to pull on the string to bring the two parts together after you placed the tape.
Zipstitch has got you covered 😉 it's just really expensive
Awesome idea and great trick for the tool bag. Very impressed
Only seen it once in a hospital for a radical abdominal cancer excision-they were called Montgomery straps. I really like this field expedient version, though. Thanks!
I was injured for the first time in bfe woods last summer with a deep puncture to the leg. the most important thing is flushing your wound. I have small saline flushes in my ifak for this exact purpose. Bleeding was profuse. I flushed, used quikclot and tightened down and IS bandage since it was non arterial... hiked to the kayaks and paddled out to the trailhead. 15hrs after the incident I got to the ER for 11 stitches. Control the bleed. Not very many reasons to stitch in the field!
Thanks for refreshing my memory on that one, I'd forgotten that method.
I'd seen that either during my SOLO or high angle rescue training with the Forest Service,, wayback.
Long retired now but good to get a refresher every once and a while though.
Wonder what else I've forgotten? Perhaps I should do a refresher course someplace just to learn some new methods and brush up on what ever I've forgotten,,,,,
Far north bushcraft and survival sent me here.... this was a fantastic survival lesson, thank you
This is a great technique. I have added a sterile stainless wire wound stapler and butterfly band aids to my kit. Minor pain, but quick and effective.
Thanks for your valuble advice-seems like a small thing, but there is the added benifit of not having your patient (or yourself) jumping around in pain from sutures..please keep the great videos coming !
Very cool, similar to a new product I saw a while back. It is essentially a bandage with zip ties and you pull them together to close the wound, it is more elegant obviously than what I described but the principle is the same as what you did.
I was never gonna sew a person's skin nomatter how badly they needed it, but this I can do. Thanks!
Love the knowledge, can't get enough of this type of content!
Listening to this made me flash back to watching 65 yrs ago, as an 8 yr old, my father, Chief Petty Officer, USN Seabees, WW I I, who had gotten hit by the fan blade in the old truck, suture himself in the other hand....five sutures. I don't think lidocaine had even been invented yet. I remember saying yes sir more frequently after that.
Made you realize the man in your father!
You arent supposed to call enlisted men sir.
@@Shorty_Lickens well get over it it’s a term civilians will always use as a term of respect if you want to deliberately misinterpret people and be a dick so be it
@@TrashMutt Awww, you're so cute!
You call your dad "Sir", enlisted or not.
You can always pre-puncture the tape to make the process go a little more smoothly. That way you're not fingering the open wound as much and it may be easier if you're doing it with one hand.
I've never even thought of something like this. Great information and helpful for field injuries but also helpful for writing. Thank you!
I used duct tape to slow the bleeding when I got cut open while hunting. I did it just to slow the bleeding till I got to the ER that was 70 miles away. Was a very scary moment in my life. I really had no clue how to field treat a wound. Started learning right there in the ER. Love your videos by the way.
I started adding those small rolls of gorilla tape to my first aid kits after watching a number of survival videos on youtube. But one day I really need to get a proper training class.
"Do you want your glasses on?" LOL poor kid
Thank you, Josh
Outstanding material and quality Josh and team!!
Cover the wound line with antibiotic ointment before tying it together. Great technique 👍🏻🇺🇸
1st time I've seen this closure method and I love it. Looks like it would work very well.
So far watched two of your videos and have to say they’re no nonsense factually correct and keep the viewer hooked. Great content keep it coming 🇬🇧.
100%, it's why we partnered with him. Josh is the man!
This video is outstanding.. thank you for sharing this knowledge that can save lives
Can you talk more about:
1) Different types of bandages?
a) hydrocolloid bandages?
b) Hydrogel bandages
c) Regular
2) Should a wound breath or be sealed?
3) Antiseptcs
4) How to clean an infected wound? I've seen wounds that are infected, and washing isn't removing the infected stuff. Its usually deep into the skin and sealed with some sort of membrane.
JK 241 yes! I would very much like to see that
There really isn't much you can do to "clean" an infected wound if the intent is to stop the infection if that is your question.
That said, and assuming you are asking the methodology to "clean" an infected wound site would consist of basic irrigation with preferably STERILE water but not disturbing the infected wound bed as you could inadvertently introduce additional debris and cause additional infection potential.
Depending upon the severity of the infection, antibiotics are most likely needed but the infected materials (skin and underlying fatty tissues) will need a proper debridement most likely via a mechanical method, i.e. scrubbing. But again depending on the severity the wound site might need substantial debridement up to including deep tissue removal followed up by skin grafts.
I know WELL about that as I had to undergo the significant debridement under general anesthesia to both of my lower legs, the left being nearly 100% circumferential about four (4") inches in height towards the lower portion of the calf muscle. The right leg wasn't as significant, with the entire surface area being about six inches by six inches (6"X6") towards the front interior portion near the ankle bone.
After nearly a month hospital stay I came home and once a month I return to the hospital to have additional staples removed.
I assure you that it is NOT a fun activity, as for the debridement, infection removal, graft and healing process and STILL taking out the staples.
Long story short, about the only thing you can do in the field to clean the wound is as described in the video and keeping the wound site as clean and protected as possible. Getting the victim to the hospital or at least a qualified medical professional and starting antibiotics is very important and timely so the patient doesn't suffer needlessly or result in sepsis and potentially MUCH worse.
Wounds should never "breath". That doesn't do shit but allow bad shit to get in.
@C W yup, thats how to do it. I learned a few years ago to pick off any scab that forms bc scabs = scars. My cousin was in a motorcycle accident in shorts & tee shirt, road rash covered her body. Tested & true. Keep it covered in bacitracin (sp), vit e or coconut oil, so it won't scab. Yeah its gross. But it works.
This is was of the best first aid videos I have seen, please, please more of the same! Thank you.
Haha I like how he went ahh and the guy didn’t flinch at all just kept going.
I've learned a ton from you . I thought I knew more about first add from the military but realized from you I need to take a wilderness first add class . thanks
Just wow. Never seen such a good idea
I'm glad I never hurt myself in the woods because over 25 years I've spent an ungodly amount of time in rural forested Oregon practically barefoot without any of these supplies lmaoo
I like this method though. I knicked myself with a hatched once. started bleeding good
I packed it with plantain leaf and wrapped it with a napkin and some wire in my nearby car I had to stem the bleeding
Good stuff. Adding items to my kit. Thanks. Won a subscriber as well.
Oh thank God. I've had my share of scrapes and cuts in the bush but thankfully never something needing stitches, and truth be told I dread the prospect of having to potentially stitch myself up. This is a workable and very clever alternative. Thanks.
A solid, practical, effective looking solution to field wound closure , Thank You!
Thank you for sharing this technique
The odds of me surturing a loved one in a SHTF situation without anesthetic is about nil, but I can pull this off. Brilliant and easy, thanks Joshua!
Extremely valuable and useful information. They, (however they are) are often stressing that learning to swim as early as possible is a good idea. As far as I can see, a bad cut is far more likely to happen to someone than falling in water and could be as potentially life-threatening. I think this general technique for temporary wound closure, like surviving in water, should be taught to people as soon as possible.
Thank you for the video. I love learning more ways to deal with first aid out in the field. Ive used duct tape to close a wound up before but never thought of doing it this way. I will say that I have used fishing line to suture myself and although it did the trick, it didn’t last long. It ended up ripping out in my sleep a couple days later and I ended up just letting the wound heal up without closing it back up. So thank you for the knowledge
200 IQ. I need to watch this channel more often. This is gold.
I got 35 seconds into this video and....you got yourself a subscriber...cause you’re spot on
Thank you again for sharing your wealth of knowledge. I had not seen the method you showed and I need to get some supplies added to my kit.
That was fantastic!!! More wilderness first aid vids, please, please, please!!!!! Good stuff to know for sure.
Thank you for such a great vid!!!
Wish I had known this in 2009. Got a nice wound on the front of my thigh from a hedge trimmer (reciprocating sawtooth type) when my foot slipped on a layer of pine straw. I let go the trigger, but just a touch was all it took to penetrate the jeans and do it's damage. I just butterfly dressed the two inch long cut, then kept working after lunch break. The wound was numb, and I thought about stitching. Luckily, I got the bleeding to stop. It wasn't a deep wound, and it healed rather well. My wife couldn't believe how I could be so calm during it all. She freaked out after seeing the blood. No, I am not ex-military.
And this is why this is one of my favorite channels on TH-cam. Thank you for this priceless info.
You know, I’m just your average joe
so to speak but that was very cool and for some reason I understood exactly what you just did.
look into Johnson and Johnson coaches tape. we use it to support our fingers(tendons) in brazilian jiu jitsu. also wrap up broken toes. stere strips are awesome instead of stitches and you can make custom stere strips with the coaches tape.
Great info here. One thing I used to use was the camelback for quick irrigation, convenient little squeeze tip on the end of a hose that's usually near what you are over... Granted you probably wont get the same velocity as you would holding it up without standing and leaning over a bit. Thank you for sharing the knowledge.
Glad he made this because I would have tried to stick the needle through a person directly 😃
You’d be surprised how many would
That's a nice tip...thank you for sharing.
I was working with my brother one time and he suffered a 2” long x 1” deep cut from a razor knife on his forearm. He totally freaked and was ready to bail for the hospital while still bleeding profusely. I made a thick compression bandage from a tee shirt and secured it with duct tape firmly till the bleeding was brought under control. Wanting something better to close the wound, I was having trouble trying to make my own duct tape steri strips stick to the area. From there I tried two large strips with of duct.tape running either side and set back a little way from the wound just about exactly as illustrated here. Then I pulled the wound closed with additional narrow strips of tape circling the entire forearm.
After making our way to the hospital and the ER nurse said that was the most amazing battlefield closure she had ever seen from an amateur. I had stopped all the bleeding and brought the wound together in near perfect alignment. Good ole duct tape is a must have for who knows what.
I’m definitely going to add this video illustration to my bag of tricks. Thanks for the sewing lesson.
As a side note I needed stitches one time and asked the doc how many times he was going to stick me with lidocaine and how many stitches I was going to get. He said he was going to inject me about 7-8 times and I needed about 5 stitches. I hate needles and I told him to just go ahead and suture me without the lidocaine. The cut was sting so bad I hardly noticed the sutures.