How to Suture a Wound - Can You DIY It If You’re Not a Surgeon?

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A good prepper should possess some first aid skills. But when can you say that it’s enough and you’re prepared regarding medical skills? We can’t become doctors in order to have knowledge and skill when it gets ugly. But, we should know how to stop bleeding and treat some wounds. Should we learn how to suture open wounds when doctors and hospitals are unavailable?

There’s no simple answer here. Stitching a simple open wound is not brain surgery. You don’t have to be a medical expert to learn the technique. With a little bit of practice, you can become pretty adept to do a decent job. On the other hand, wounds that need emergency stitching are very rare. Also, making the right call is more important than the technique (more on that later on). Most survival experts would say that it’s not an essential skill, but it won’t hurt if you can perform it.

So, it comes down to you to make the decision. While stockpiling prepper gear can easily turn into hoarding, extra skills don’t require additional space. Therefore, if you have some spare time, acquiring a new skill is always a good idea. However, when it comes to medical skills, you should be meticulous and pedantic. With half-way learned skills, you can make things worse instead of better.

What Exactly Is Suturing?

It is basically a surgical skill. When we talk about emergency uses of the technique, it is a way of stitching the skin to close wounds. Certain deep injuries require suturing. By bringing the wound margins together, you are eliminating dead space and aligning damaged skin and tissue.

This will provide support to the wound and allow for better healing. It also reduces scarring, even though it probably won’t be your top priority. Furthermore, closing the wound will reduce the risk of bleeding and infections.

Why you Should Learn How to Suture a Wound

We have already established that it’s not a must-have skill.

However, in disaster scenarios, you may not have another option but to try to stitch a wound. Imagine you’re in the remote wilderness with a couple of friends. You’re practicing your primitive skills, your phones are out of range and it’s a two-day walk to the nearest town. One of your friends uses a hatchet or tomahawk to chop up some firewood. He misses the wood and hits his leg making a deep, nasty cut.

Bleeding is the greatest danger so it’s a top priority to stop it. But, let’s say that he has missed major arteries and veins so the bleeding was not a problem. An open gaping wound would likely get infected unless there’s someone to clean it and close it. So, you have only two options: to pray or to stitch the wound.

In SHTF scenarios you may not have any kind of access to hospitals or doctors, so it’s completely up to you to make decisions.

Obviously, knowing how to suture wounds would be convenient in the aforementioned situations.

When You Should Stitch a Wound

Mastering the basic technique of suturing is not too complicated. Truth be told, there are many techniques and styles, but non-professionals should stick with the most basic technique. Using a suture pad will allow you to practice and become quite proficient. However, it’s more important to identify situations when you should apply this technique.

Rule number one is that it should be the last resort if you have no other choice!

In order to understand when you should close the wound, you also need to know when you shouldn’t do it. Superficial cuts, scrapes, and all minor wounds should be left to heal naturally. After you clean them, that is. Even small open wounds can be closed with butterfly bandages or steri-strips.

When it comes to large gaping wounds, stopping the bleeding is a top priority. Closing a bleeding wound is not only difficult but also wrong – it would only make things worse.

Larger injuries with torn skin and tissue aren’t suitable for stitching. Not even surgeons could stitch them together efficiently. So, once again, all you can do is to clean it, stop the bleeding, and let it heal naturally.

Finally, you shouldn’t resort to suturing if the wound is dirty or contaminated unless you can clean it properly.

By now, you must wonder if the suturing is ever needed. Well, it is. Deep, gaping, clean-cut, larger wounds won’t heal naturally. So if you don’t have a problem with bleeding, stitching is the best option. If you don’t do it, you’re risking an infection that can lead to further complications. Finally, you can put your skill to good use.

How to Suture a Wound?

Medical interventions should never be taken lightly. In survival movies it seems pretty simple but it isn’t. It is usually better not to do it than to do it incorrectly. Even though it’s an emergency situation, you should follow the procedure to the letter.

Step 1. Get All the Supplies

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You don’t want to start suturing only to find out that you’re missing a piece of your equipment. Get everything ready so you can focus on your job. This is what you’ll need:

Forceps. It is a tool that allows you to manipulate the tissue and skin around the wound while suturing.
Needle driver or needle holder. Hand sewing is okay when you mend your clothes. To drive a needle through the tissue, you’ll need a needle driver. It allows you to manipulate the needle without straining or stretching the wound.
Sterile needle and thread. You can’t sew without a needle and thread.
Scissors. You need them to cut the thread.
Gauze. You’ll need it to clean the skin around the wound.
Antiseptic. You should use Betadine or something similar to disinfect the skin around the wound. However, make sure that you don’t apply it directly to the wound. All disinfectants will slow the healing process.
Surgical gloves. Gloves protect both the patient and performer from cross-contamination.

Step 2. Irrigate the Wound

Use potable water to irrigate the wound. It should be enough to remove foreign debris and potential bacterial load from the wound. Organic debris such as clay and dirt is particularly dangerous so make sure to get it all out.

Sterile solutions can make the wound worse, so you should only use them to clean healthy skin around the wound. Apply it in a sort of circular motion moving away from the wound.

Step 3. Suturing the Wound

There are many types of sutures. However, the most common and simplest to perform is the interrupted suture. Individual stitches aren’t connected, hence the name. It is not the fastest suturing technique as placing and tying each stitch takes time. On the other hand, these stitches have high tensile strength, and even if one stitch fails the rest is unaffected and the wound stays closed.

Creating an Interrupted Stitch

Wash your hands and put the gloves on. Use a needle driver to grab a needle. Let the needle pierce the skin at a 90-degree angle, at approximately 5 mm from the wound. It depends on the wound how deep you should go. You want to close the wound not only at the surface but in the depth as well. Otherwise, you’ll leave dead space and that’s not good.

Once you reach the desired depth, rotate your wrist so that needle comes out of the middle of the wound. This is called “the first bite”. The second bite is basically the same, only this time you go from inside the wound to outside. The needle should come out of the skin perpendicularly at 5 mm from the wound. Make sure that bites are parallel and reaching the same depth. Also, use forceps to hold the tissue and keep it stable.

Tying the Knot

Now, pull the suture through until you get 2-3 cm out there at the opposing side. Hold the suture in your non-dominant hand and make two loops around the needle driver. Larger loops will allow you to manipulate more easily. Grab the tip of the suture with a needle driver on the opposing side (those 2-3 cm sticking out of the skin). Pull and bring the suture across the tip of the needle driver and you have your first knot. Make it reasonably tight and release the needle driver. Make another loop around your needle driver, grab the suture end, and tie a second knot. Repeat the process to tie the third knot. Cut the excess thread with scissors and there you go! You are not a surgeon but you tied a surgeon’s knot and finished your first stitch!

The knots should not be placed directly on the wound but to one side. It will allow easier removal of stitches as well as prevent scarring.

Continue placing sutures with 1 cm intervals until the wound is closed. Voila! Job done.

4 Additional Tips

Even though it is a pretty simple technique if you ever get to use it, you’ll do it in an emergency situation. While doctors usually apply numbing agents to make it painless for the patient, you won’t have that luxury. So, you need to be calm and confident. And you can achieve this only by practicing.

Buy a suturing kit. A suturing kit contains all you need to perform this task. Moreover, most of them come with a suturing pad for practice. That’s where you’ll hone your skill. And if the time comes to show it, you’ll be ready.
Hold the tools correctly. If you want stability and control you need to use tools correctly. You should hold a needle driver with your ring finger and your thumb. This is a proper grip for beginners even though surgeons usually just hold them in their palm. But it takes a lot of hours to become adept enough to do so.
Use your index finger to improve control. When you grasp a needle with your needle holder, put your index finger close to the tip of the needle holder. It will help with stability and precision.
Support your hands. If you can rest your elbows or wrists, you’ll be more steady. And you need steady hands to do the job.

Conclusion – Know Your Suturing Basics

Suturing the wound is not rocket science but it’s not a game either. While it’s good to know how to do it, it’s even more important to know when to do it. And these things are easy to forget unless you practice and refresh your knowledge every once in a while.

So, you don’t have to be a surgeon to be able to stitch a wound. Nevertheless, you should be very careful and use this technique only when there are no professionals available and you’re positive that it should be done.