[pct-l] Stitches

Wed Feb 23 12:58:02 CST 2011

I recommend anyone interested in this topic do a little google research.
>From what I gather, the medical glues are actually different from superglue.
They are similar and in the same chemical 'families', but they are
formulated to reduce skin irritation and be more flexible.

I made a pre-hike visit to my Dr last week. I didn't think to ask about
this, as I am not planning to NOT take my little tube of super glue. It's
just too handy for other things as well. Something he said does seem
relevant though, so I will share. We were discussing what sorts of medical
issues I might face in the back country and what, if anything, I should
carry to treat it. He did give me some pain killers and Flagyl (not sure of
spelling, the stuff for giardia). His concern was diagnosis. I asked about
infections and should I carry antibiotics. He wasn't strongly against it,
but he advised that it would be best to go to a clinic for them. I took his
advise on that one. My concern was more with the rash type infections I've
heard of, and he felt it was uncommon and I shouldn't worry about that.

The point I'm trying to make is, we're not medical professionals. He kept
stressing that if I had any problems, I should try to get medical attention
asap. Anything we do in the back country is a temporary measure hopefully.
When I first got my WFR cert, back in the 90s, my first aid kit was huge.
We're talking 3-5 lbs! I'm older, and hopefully, wiser now, so I've trimmed
it down substantially. I try to keep it as basic as possible. I do this by
thinking about what conditions I want to prepare for. Anything not on that
list, I'll have to improvise. If I encounter a compound femur fracture or a
sucking chest wound, things are so bad at that point, anything in my ultra
light first aid kit is probably NOT going to be what determines the outcome,
it's what's in my head. I have chosen to be prepared for a cuts though. In
my experience, the biggest problem with treating a cut is avoiding it
reopening. Yes, I can use the little adhesive butterflies or suture type
things, but they don't stick real well to a dirty and sweaty hiker.
Superglue does. I don't flood the wound. I apply the glue like stitches. I
make lines perpendicular to the wound. This lets it ooze, but does a
fantastic job of holding it closed. Sometimes the cuts are in places that
the skin is constantly being stretched. Adhesive bandages have never worked
as well for me. Again, I've only had to resort to this twice in decades of
hiking, but it worked great for me.

Once again, I'm wrong about everything I'm saying, so do NOT take any
medical advice from me. This is all my opinion based my life experience.
Make your own choices. Talk to your doctor, your mom, your preferred
religious figure, or whomever's opinion you respect about this. If you make
a decision about how to prepare for a medical emergency solely based on what
people post to an email group, that's a little cray IMHO. The folks on this
list are great, but especially when the subject is this important and
getting such varied opinions, talk to an authority.

No offense to anyone on this list. Some of you very well ARE experts, but
unless I know you personally, I am not going to trust my medical care to
you. ;)

On Wed, Feb 23, 2011 at 6:18 AM, Jeb Bates <batesjeb at yahoo.com> wrote:

> I have a friend whose mother is a chemist and works for a company that
> produces surgical grade super glue.  I have been told the the stuff is worth
> somewhere in the thousands of dollars per gallon range so by extension, a
> small vile is very expensive.  While it is sterile and in theory is "better"
> I cannot imagine anything living in normal superglue long enough to mess you
> up. Plus the sterility of anything is compromised when a thru-hiker gets a
> hold of it so it really doesn't matter.
>
>
>
> ------------------------------
> *From:* Melanie Clarke <melaniekclarke at gmail.com>
> *To:* Kevin Cook <hikelite at gmail.com>
> *Cc:* pct-l at backcountry.net
> *Sent:* Tue, February 22, 2011 9:49:17 PM
> *Subject:* Re: [pct-l] Stitches
>
> Dear PCT,
>
> My son's Cardiologist (congenital heart defect) told me how they were using
> "superglue" (surgical grade) in pediatric heart surgeries in the same year
> that I hiked the JMT.  I told him how Superglue was part of my first aid
> kit
> for the JMT.  He wasn't too disturbed and I think mentioned that it was the
> same stuff except for the guaranteed sterility of the surgical grade stuff.
> I think there are going to be more pathogens introduced by the dirt on the
> trail than from the superglue tube.  Surgical grade has to be used in open
> heart surgeries where health is fragile and the health and immune system is
> already compromised.  You are not going to get a doctor to prescribe
> regular
> superglue for you as they can get sued but my son's Cardiologist did not
> try
> to stop me.  He thought my UL first aid kit was great and clever!
>
> Melanie
>
> On Tue, Feb 22, 2011 at 3:56 PM, Kevin Cook <hikelite at gmail.com> wrote:
>
> > I got my info about super glue from my WOFR instructor. It was awhile ago
> > (like 20 years almost), but that's what I know.
> > I've used super glue to close wounds. It works great. This was after
> > applying "well aimed, direct pressure" and getting the bleeding to stop.
> > The
> > glue just kept the wound from reopening. I also bandage them as well. I
> > don't recall being told NOT to use alcohol, but that the time I didn't
> > carry
> > alcohol. We just flushed with the cleanest water available as per
> > instructions. I'm willing to give up the alcohol idea. Seems like there
> is
> > a
> > reason they use it in the hospital though.
> >
> > I'm gonna have to question the glue needing to be surgically removed.
> When
> > I
> > used it on myself, it came off like a scab as the cut healed. I'm not
> > suggesting you pour it into the bottom of the wound. I use it to just
> close
> > the wound at the skin. I've only done it twice. Both times on cuts that
> > were
> > going to likely keep reopening without the aid of super glue.
> >
> > If you really want the "good stuff" there is this:
> > http://www.amazon.com/exec/obidos/ASIN/B00061MUAG/ref=nosim/kkorg-20
> > This is like the stuff used everywhere outside the US for years. The FDA
> > never approved super glue because it can cause skin irritation. They have
> > finally approved this new variant:
> > http://www.amazon.com/Dermabond-Topical-Adhesive-5ml-vial/dp/B0024L19I0
> >
> > HYOH, and do NOT listen to me for medical advice, ever! I'm not spending
> > the
> > extra $$ though. I'll carry the tiny little bottle of super glue the same
> > as
> > I have for almost 20 years. It can be used for lots of other things
> besides
> > wound care as well. Multi purpose is the goal, right? ;)
> >
> > On Tue, Feb 22, 2011 at 3:39 PM, Eric <johner27 at evergreen.edu> wrote:
> >
> > > Paul, I definitely agree with you. I recently completed a WFA course
> and
> > > our
> > > professor repeatedly told us to just clean with water.  Also, as far as
> > > super glue goes, I hope everyone would NOT use it as if you close a
> wound
> > > with this, the glue will need to be surgically removed.  The better
> > > solution
> > > would be to stop the bleeding, wrap the wound, and get out of the
> > > backcountry ASAP.
> > >
> > > Regards,
> > > Eric
> > >
> > > On Tue, Feb 22, 2011 at 11:17 AM, Paul Robison <
> > paulrobisonhome at yahoo.com
> > > >wrote:
> > >
> > > > Sorry to chime in like this but it is VERY VERY important you don't
> > clean
> > > > with alcohol if medical attention is not near...
> > > > ...Secondary infections like gangrene and other worse options are
> > caused
> > > by
> > > > alcohol cured wounds.  Alcohol destroys simple bacteria but t also
> > > destroys
> > > > your body's antibodies in the area, leaving your wound as basically a
> > > Petrie
> > > > dish for whatever the strongest thing there happens to be
> > > >
> > > > Unless broad spectrum Antibiotics are available within a day, DO NOT
> > > clean
> > > > with alcohol.  Irrigate with water and leave he bacteria alone until
> > > medical
> > > > help is around...
> > > >
> > > > About superglue... Try make a non toxic glue made from
> > > > polyacrimides<(spelling?). That are inert, but it's like 60$ a tube
> at
> > > > amazon.
> > > >
> > > > I'll take a little blood poisoning on the far outside chance that
> could
> > > > happen.  Superglue is mildly carcinogenic in the blood stream, but so
> > are
> > > > thousands of other polymer based products we put on our skin.
> > > >
> > > >
> > > > ... Btw, this is much more important in bush situations,  but assess
> > your
> > > > own safety... Most likely if you get hurt you'll be found in an hour
> or
> > > two,
> > > > but in some places it could be a while.  First aid is a seriously
> > > important
> > > > skill and I recommend everyone study what he us marines do for
> medical
> > > > attention... Their field medics (navy medics I believe? Unsure) are
> the
> > > > best.
> > > > Sent from my iPod
> > > >
> > > > On 2011-02-22, at 12:24 PM, Kevin Cook <hikelite at gmail.com> wrote:
> > > >
> > > > > Mr Bulk is right, use super glue. Some alcohol can be used to
> > > disinfect,
> > > > > then close the wound with super glue. The medical industry won't
> > openly
> > > > > endorse this, but it's a pretty common practice. There are 2
> concerns
> > > > with
> > > > > this though. First, it creates a very well sealed closure to the
> > wound.
> > > > > While this is good for keeping things out, it also keeps anything
> in.
> > > > > Irrigate and clean the wound well before closing! Second, the
> medical
> > > > folks
> > > > > are concerned about the glue being absorbed into the body. While I
> > > > haven't
> > > > > heard anyone say it's bad, it's reasonable for them to err on the
> > side
> > > of
> > > > > caution. My theory is, we're exposed to so many toxins in modern
> > > society,
> > > > > the risk associated with using super glue to close a wound is
> > probably
> > > > > smaller than the risk of not dealing with the wound.
> > > > >
> > > > > I carry a tiny bottle of super glue in my first aid kit. Actually,
> > > thanks
> > > > > for reminding me of this, I should probably get a new one. Mine is
> > > > several
> > > > > years old. It's unopened, but for $2, I think I'll replace it ;)
> > > > >
> > > > > On Tue, Feb 22, 2011 at 9:09 AM, Nitnoid1 <nitnoid1 at yahoo.com>
> > wrote:
> > > > >
> > > > >> Super glue may work but you would have to look it up. I've heard
> it
> > > > being
> > > > >> used in emergency situations far from an ER.
> > > > >>
> > > > >> The Incredible Bulk
> > > > >>
> > > > >> On Feb 22, 2011, at 8:03 AM, Amanda L Silvestri <
> > aslive at sbcglobal.net
> > > >
> > > > >> wrote:
> > > > >>
> > > > >>> I have always been careful while out hiking/backpacking and so
> have
> > > > never
> > > > >> yet been cut much worse that a scape or scratch, never the less,
> it
> > > > seems to
> > > > >> me that the possibility of tripping or falling (off a slick log or
> > > loose
> > > > >> rock cliff or whatever) or impaling oneself with a branch, is a
> > > > possibility.
> > > > >> Even so, I have yet to see in the content list for a First Aid
> kit,
> > a
> > > > >> curved needle for stitching up lacerations.  I would not enjoy
> > having
> > > to
> > > > do
> > > > >> this, but I can imagine a situation where a butterfly bandage
> might
> > > not
> > > > be
> > > > >> enough.  It is likewise not hard to imagine this happening some
> days
> > > > away
> > > > >> from a road crossing/trail head.  Does anyone carry anything for
> > > > stitches in
> > > > >> their First Aid kit or do most people just use regular needle and
> > > thread
> > > > (or
> > > > >> dental floss) hoping that will do the trick?
> > > > >>>
> > > > >>> Shepherd
> > > > >>> _______________________________________________
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> > > --
> > > Because we don't think about future generations, they will never forget
> > us.
> > > ~Henrik Tikkanen
> > >
> > > “The things you own end up owning you.”* -*Tyler Durden, *Fight Club*
> > >
> > > "The three most harmful addictions are heroin, carbohydrates, and a
> > monthly
> > > salary."—David Hieatt
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