Deep Cuts (First Aid)

[GPSGuided]

Lee737 is correct. If there's bone damage and is exposed through a wound, then that's 'compound'. Fortunately most are not life threatening hence not necessarily a surgical emergency. A degree of urgency yes but not always an emergency.

[Moondog55]

My online dictionary is wrong then No surprise I suppose

I do think tho that labelling something where there is no break in the bone a "fracture" is a step in the wrong direction.

[GPSGuided]

No one said that the term 'fracture' is used when there's no 'break'. When there's a crack (damage) on the bone, it's a fracture. Fracture does not always have to be complete. 'Stress fracture' is another where the damage is relatively minor.

[Moondog55]

If the bone is damaged, we call it a compound fracture.

This is the quote I was confused by
Bone can be damaged but not cracked or broken. In my query I was asking about cuts and abrasions to the myelin sheath which I have had several times when I cut myself at work and once on my shins when skinny skiing in shorts when I scraped my leg with a sharp edge

[GPSGuided]

It would be a really fine observation to be able to differentiate myelin sheath 'abrasion' on peripheral nerves. Not a level of differentiation needed in clinical application.

[Moondog55]

I think tho if I was making a "000" call I'd probably be giving the ambos more accurate information if I said a deep laceration with exposed bone rather than saying a compound fracture wouldn't I??
Which description, if any, would make their job more efficient and which description would enable the phone operator to best assist me?

[GPSGuided]

No difference really. You should be informing on the patient's location, consciousness, major injuries, ABC and any specific difficulties. A fracture, compound or not is not that big a deal if the patient is stable and not suffering from significant blood loss. A simple 'broken leg' is all that's required in effect. Infection is not a parameter given the acuteness of the event. All the details can be managed by the ambulance, one with resuscitation and transport roles. The rest will be managed by the hospital.

[Nuts]

Maybe the situation is (sadly) just no longer necessary, or thought necessary, to consider in our shrinking world, not easy to fathom or perhaps it is just that the chances are so remote. I had in mind limited possibilities for evacuation, third world or following a natural disaster.. , longer term management, that's what I got from it (that dressing technique wasn't my idea).

I've had some formal training and practicie in suturing as well and with just those situations in mind. It's understandable, though always a bit deflating, to see medical professionals turn to their box of correct terminologies and responses, the default resting on calling the ambulance. It's ok, I don't much care what is discussed in any topic on here (other than the pervasive flippant attitude to sensitive places) and probably more relevant discussion to bushwalking injuries and common scenarios ... just not what I had in mind with the initial post.

Hopefully the image itself evokes another arrow in a "first aiders" quiver.. maybe never used other than promoting thought process. (Im not sure why 'hope', hard to shake free the training, 'to care' )

[Moondog55]

Nuts I've a lot of "First-Aid" training but I would never attempt to suture.
I have thought about the technique in your first post and while it does have interest it probably isn't relevant more often than not as I may not have the big needle and thread or the easy tear tap in my repair kit
But as a way of keeping a deep wound from getting any more dirt in it and helping to keep the wound clean I can see it having merit, my post about stopping my guts from falling out was light hearted but not at all flippant
It is true tho that in most of the country good medical emergency care is usually only 48 hours away

[andrewa]

Nuts, I actually think it's a good concept (and I'm a doctor!).

I can think of one situation in my existence where it could have been used - I suppose the "deep cuts" concept bought out those wishing to define "deep", so, for what I will term a deep "skin" laceration, it looks like it could work well.

Andrew A

[Lindsay]

I too have had formal training in suturing, and when I was in the navy I was called upon to do it on occasion. However I don't have the equipment (suture set, local anesthetic, needles, syringes) in my first aid kit so suturing a wound in the bush is a moot point. Standard first aid practice is the best way to deal with deep cuts in the bush rather than attempt anything more complicated.

[Moondog55]

Lindsay I think Nuts point was that this isn't exactly suturing as such
It was a way of closing a wound in a similar fashion but using normal sewing needles to sew thru the doubled over edges of the sticky tape.
Maybe deep cuts are never going to be part of most walkers experience but as a climber I've seen quite a few.
Crampons are very sharp at the start of a climb and if somebody slips and you're in the way you tend to get cut quite badly, ropes etc not much help sometimes. Didn't happen to me, a different party on the way down while in Scotland decades ago. "Och It's only a wee scratch!"

[GPSGuided]

One thing to bear in mind with wound care out there is tissue preservation. Don't try DIY suturing or other fancy procedures in sub-ideal conditions as they would cause more damage and contaminate more tissue areas. Unless one can't be evacuated within a reasonable amount of time (days), the best solution is to follow the KISS principle. Saying again, the original post's wound closure design is not new and the concept is only of use to superficial skin wounds or for wound tension control. Compared with traditional first aid solutions (pad/bandage) in a first aid situation, it's an inferior method when the wound gets deep.

[Lindsay]

Lindsay I think Nuts point was that this isn't exactly suturing as such
It was a way of closing a wound in a similar fashion but using normal sewing needles to sew thru the doubled over edges of the sticky tape.
Maybe deep cuts are never going to be part of most walkers experience but as a climber I've seen quite a few.
Crampons are very sharp at the start of a climb and if somebody slips and you're in the way you tend to get cut quite badly, ropes etc not much help sometimes. Didn't happen to me, a different party on the way down while in Scotland decades ago. "Och It's only a wee scratch!"

I should have added that I think Nut's idea is a good one, I would certainly use it if needed. Maybe I was reading the OP wrong as I was thinking of the definition of a 'deep' cut as being through the skin and into the muscle. Such wound may require internal suturing and special techniques that are beyond the ability of most of us, and to close such a wound with surface sutures can do more harm than good.

[lee737]

If you have the duct tape - just use that, why muck about sewing between the edges? If it is a fairly superficial injury, you may just effect a primary closure that way, if it deep, and in need of surgical exploration, then the doc can peel it off, debride the wound and do what's needed. In this day and age in this country you need never be more than a day or so from specialist level care, so just control blood loss, do your ABCs and wait.... if you are truly remote, then do the same, just cross your fingers longer! And maybe carry some antibiotics with you....

[Nuts]

'Deep' was the term copied from the article (or from someone sharing the article, I can't recall) .. Fair enough. And I agrree with most of the comments. I'd not tape directly over any cut.. And you don't really even need the needle.. but anyway. All good.