firedoc5 Posted October 23, 2008 Posted October 23, 2008 Well, I did it again. As some of you know I've been falling a lot (I've got like three tests coming up to find out why) but I've been having to use crutches. I don't use them in the house though. But last night I fell and this time I took out my wife's antique china cabinet. To make a long story short. I had mostly scratches from the glass except of one area. We used butterflies and some band aids and thought we'd see how it did doing the night. Well, it still kept bleeding. This happened around 10:15 last night. Since my boy totaled out my truck I had no transportation. My mother in law finally came and got me to the ER. The doc said that if I came in an hour earlier he would have put in 3-5 sutures. But since it was past time he didn't want to suture it. So they used that glue stuff and steristrips. Of which, when using my crutches I know I'm going to tear it back open. My question is, and I know it's different from doc to doc, but I've heard ten hours, 12 hours, and even 24 hours to limit the time for the use of sutures. What have y'all heard? Luckily I didn't wind up in the ER to get 16g. buckshot out of my butt. My wife was pretty upset.
Dustdevil Posted October 23, 2008 Posted October 23, 2008 There is some fudge factor, but eight hours is the generally accepted standard.
firedoc5 Posted October 23, 2008 Author Posted October 23, 2008 There is some fudge factor, but eight hours is the generally accepted standard. If I could have found transport sooner I'd been there within eight hours. Actually, 8.5 hours.
emtannie Posted October 23, 2008 Posted October 23, 2008 Firedoc, sorry to hear about your injuries.... Just curious... I have heard the "8 hour rule" too. What makes 8 hours the generally accepted standard? Is it because of healing that is already taking place in the wound? Is it because of tissue death around the wound site? And in firedoc's case, if it is in a location where it will continue to re-open and continue to bleed, even if it is after that 8 hour time frame, wouldn't it be better to ensure that the wound stays closed by using sutures rather than steri-strips? Just wondering...
firedoc5 Posted October 23, 2008 Author Posted October 23, 2008 Firedoc, sorry to hear about your injuries.... Just curious... I have heard the "8 hour rule" too. What makes 8 hours the generally accepted standard? Is it because of healing that is already taking place in the wound? Is it because of tissue death around the wound site? And in firedoc's case, if it is in a location where it will continue to re-open and continue to bleed, even if it is after that 8 hour time frame, wouldn't it be better to ensure that the wound stays closed by using sutures rather than steri-strips? Just wondering... They say it's a time factor for infections. Even healthy skin has infections and if the wound is large enough they "think" that within a certain amount of time there is too "bugs" got it. But like I said, I've heard so many time factors, I don't know what is acceptable anymore. Right now this thing is driving me nuts, just typing. just proximal to my wrist and every time I use that forearm muscle I can feel it move. And I was lucky. Had one "scratch" about 3cm from my radial artery. Just think if that was deeper and long.
Arizonaffcep Posted October 24, 2008 Posted October 24, 2008 So they used that glue stuff and steristrips. Of which, when using my crutches I know I'm going to tear it back open. In the ED, we just had an inservice regarding this stuff (specifically Dermabond). Once it fully dries (after the second application) which is about 15 minutes or so, it has a burst strength of a 4.0 suture. Plus, it has antimicrobial properties.
reaper Posted October 24, 2008 Posted October 24, 2008 Dang man, ain't you ever heard of 911? They come pick you up and give you a nice bed to lay on. They got a/c and everything. Best of all, it's all free! You should try it some time.
Ridryder 911 Posted October 24, 2008 Posted October 24, 2008 I was taught in NP 2-4 hours for facial and up to 8 hours for other. The reaon is for infection but the proximate edges become dry and non pliable. Yes, one can incise and attempt to use better tissue that is if it is possible. Usually it is loosely placed together to prevent dehiscence.
Eydawn Posted October 24, 2008 Posted October 24, 2008 When I was a small child I waited 7 hours for sutures in my cheek. I still have a nice scar from it, fortunately faded. So much for that rule... Wendy CO EMT-B
firedoc5 Posted October 24, 2008 Author Posted October 24, 2008 Dang man, ain't you ever heard of 911? They come pick you up and give you a nice bed to lay on. They got a/c and everything. Best of all, it's all free! You should try it some time. There is no way I'm going to call and tie up the only ambulance in this immediate large rural community. Thought about it, but my conscious wouldn't let me. Come to think of it. They only applied the Dermabond once. I just now took off the wrap dressing and there has been a seeping on one end, but not bad. Looks pretty filthy, but they say I can shower with it, so...If it comes undone again... :evil1: I assure you someone is going to hear about. I have too many low friends in high places still in the region. I'll let you know.
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