local anesthesia

[Fido]

Something else to consider is that in a non-clinical setting it may be better to not stitch the wound. If it deep and needs internal stitches it may be better to allow to drain as it heals from the inside out. Current guidance from the American Red Cross Wilderness first aid is: seek stitches if the edges of the cut don't align when pulled together, its longer than 1 inch, it doesn't stop bleeding in a reasonable time,its on a joint that won't stay closed when the joint is moved, and it can be done within 24 hours.
Another reason for allowing it to stay unstitched if its deep is there may be contanimation within the wound. Thus making it necessary to clean it often.
I would suggest that for most wounds folks learn how to make 'butterfly' closures and use them first.

Good point.
Last year I tried to fall off of my roof. The only thing that stopped me was the top of my ladder which dug itself into the back of my knee and created a deep puncture wound. The E.R. Doc refused to stitch it because he was very concerned about an infection setting in.
I would think that if it is a SHTF scenario and you cant properly clean the wound and no antibiotics are available, it would be best to leave the wound open and bandage it to keep it clean. The seeping of blood will eventually wash out the gunk. Sure you'll have nasty scar but at least you won't have an infection.

[Megan]

Something else to consider is that in a non-clinical setting it may be better to not stitch the wound. If it deep and needs internal stitches it may be better to allow to drain as it heals from the inside out. Current guidance from the American Red Cross Wilderness first aid is: seek stitches if the edges of the cut don't align when pulled together, its longer than 1 inch, it doesn't stop bleeding in a reasonable time,its on a joint that won't stay closed when the joint is moved, and it can be done within 24 hours.
Another reason for allowing it to stay unstitched if its deep is there may be contanimation within the wound. Thus making it necessary to clean it often.
I would suggest that for most wounds folks learn how to make 'butterfly' closures and use them first.

Good point.
Last year I tried to fall off of my roof. The only thing that stopped me was the top of my ladder which dug itself into the back of my knee and created a deep puncture wound. The E.R. Doc refused to stitch it because he was very concerned about an infection setting in.
I would think that if it is a SHTF scenario and you cant properly clean the wound and no antibiotics are available, it would be best to leave the wound open and bandage it to keep it clean. The seeping of blood will eventually wash out the gunk. Sure you'll have nasty scar but at least you won't have an infection.

Great insights. I will be sure to remember that.

[Matt In Oklahoma]

So the mother in me is thinking -- would you still say this about children? If something awful happens to my child, do I suture them up still w/o anesthetic? I have had stitches done with a local anesthetic, and I have to admit that it was pure relief after that area had numbed. And I was grateful that I was totally numbed when I was getting stitched up.

I have watched my son get staples with none and yes I still have a heart and teared some later but it had to be done, I'm not a heartless knuckledragging man and can't stand to see my daughter cry but I'm just being realistic about SHTF as opposed to having a controlled substance and going to prison where i'm no good to anyone. Also look into something like celox and butterflys for a less painful way of stopping the blood. That way it can be cleansed as EXE121 talks about

[GAGLOCK]

A lot of burn cream products main ingredient is lidocaine.

http://www.envirosafetyproducts.com/burn-ointment.html

Burn Cream with Lidocaine from Medique provides pain relief from minor cuts, abrasions, burns and skin irritations. Lidocaine is a local anesthetic (numbing medication). It works by blocking nerve signals in your body.

[monkeybird]

Not suturing a wound is always a viable decision. In fact, there are wounds that are left open to heal on their own. It's call 'healing by second intention' don't ask me why. Never, never suture an animal bite, or human one for that matter, they have a very high rate of infection.

Lidocaine is not essential at all, but it makes life a lot more pleasant if suturing is required. The decision to suture is based on the depth of the wound and the amount of bleeding. Suturing allows a fairly clean wound to heal more quickly.

I assisted in hundred and hundreds of suturing. 8 out of 10 times it's done to quicken healing. It is NEVER done to a grossly dirty wound or a bite! For wounds that are not deep, super glue will do the trick. Butterflies are a good alternative.

The most important thing is to keep the wound CLEAN whether it's sutured or not!

[Patriotic Sheepdog]

Make friends with a Doctor, PA, NP or pharmacist. These drugs need to be used with caution as there are side effects. Lidocaine is used often in many medical offices.

[Matt In Oklahoma]

After doing some looking and thinking it appears as topical may be the best one can come up with possibly without going over the line. I have solarcain and I saw some other interesting things while researching. There seems to be some numbing pain relief creams that contain lidocaine and well some err uh well "after hours activity" numbing agents that might be worth looking at. If these were applied near but not in the wound channel it might be worthwhile. Trying to think outside the box
Thoughts?

[1Admin]

We used some lidocaine that was about 5 years out of date once debriding and cleaning out a huge boil (an alien was actually living inside) of a family member. We had to use a little more than normal in raising a wheel around the wound. But the family member had been drinking also, so that may have had some cause.

[Hidden Agenda]

Although alcohol has been used for centuries to provide "pain relief", keep in mind that (depending on the quantity) it may thin the blood, leading to increased blood loss.

Having had more than a few sutures and staples in my life, and not always with numbing agents, I can speak form experience when I say that the sutures don't hurt nearly as bad as properly cleaning the wound. Irrigating the wound with some saline and/or betadine and/or peroxide may not be enough, (it rarely is) depending on the mechanism of injury. A good thorough scrubbing may be necessary. That (in my experience) it what hurts!

As previously mentioned, in austere conditions, it may be best to allow the wound to "weep", and to focus on cleaning and protecting the wound.

[Patriotic Sheepdog]

Ice applied locally can help "numb" the pain a bit. Now having ice in a grid down may be difficult for some. There are some dental products like Anbesol that may help also, but you may be able to get some psychological benefit also. I just checked Amazon and they have Topicaine which is topical Lidocaine 4% for $16.50 for a 10g tube - no Rx needed. It would help some, but won't take the pain away like injected Lidocaine. Still probably better than nothing. Just be sure you follow the directions. Applying to much to a large body surface can result in a toxicity.

[Matt In Oklahoma]

Ice applied locally can help "numb" the pain a bit. Now having ice in a grid down may be difficult for some. There are some dental products like Anbesol that may help also, but you may be able to get some psychological benefit also. I just checked Amazon and they have Topicaine which is topical Lidocaine 4% for $16.50 for a 10g tube - no Rx needed. It would help some, but won't take the pain away like injected Lidocaine. Still probably better than nothing. Just be sure you follow the directions. Applying to much to a large body surface can result in a toxicity.

Thanks so those type of creams might be the ticket. If this type of stuff doesn't work I'm going with the Major Payne "let me see ya little finger" trick LOL

[Patriotic Sheepdog]

Thanks so those type of creams might be the ticket. If this type of stuff doesn't work I'm going with the Major Payne "let me see ya little finger" trick LOL

Think years ago...swig of whiskey and a wooden bite block. If the pain was too bad, the patient would pass out. Of course, the patients had to be tied or held down to the table before surgery was started....also, the outcomes weren't all that great.

[1Admin]

PSD- some SF medics that trained us about 20 years ago said sterile water could be used as a (very) temporary local block. What is your thoughts on that? We always had some lidocaine even if it was older, so I never got to try it.

However sterile water can sometimes be found at Vet supply places.

[Patriotic Sheepdog]

Some countries use sterile water injections for back labor pains during delivery according to a quick web search I just did. I had not heard of this, but it is a small amount of sterile water injected intradermal. I guess in theory it would cause some swelling and may diminish the pain sensation to some degree. I'll try and research it and report back.

[Patriotic Sheepdog]

Since Dermatology practitioners know the skin, what better than to look in some of their literature.

Sterile saline seems to be preferred, especially preserved sterile saline by one derm. Seems to be safe, but wouldn't use for something deep.