Monday, January 10, 2011

Learning how to suture

As Maid Elizabeth prepares to go to midwife boot camp, she is brushing up on numerous skills that she has already mastered and learning new ones.  One of the most valuable new skill she has been learning is suturing.  Although for most ladies, sutures are not required, there are some that tear badly and require a stitch here and there.

The beauty of learning suturing is that is crosses over to so many medical emergencies, not just midwifery.  Maid Elizabeth is learning how to tell the difference between muscle, skin and fat.  Each layer requires different stitches and different suturing mediums.  Some flesh requires gut to suture and other requires dissolving synthetics.  She is learning not only how to suture, but how to deal with veins that are involved in trauma.

The applications for the preparedness minded family are so many!  Any number of medical traumas require sutures, and a trained midwife is as good as a surgeon in those situations.  Not only is she acquiring the skills, she is learning to properly administer pain management pharmaceuticals.

As you can see, Maid Elizabeth, being an EMT and soon-to-be Midwife, is our duly appointed medical expert.  Not only will she provide a great service to many ladies in the Philippines and our small town, she will be worth her weight in gold when the balloon goes up!

Maid Elizabeth's surgical kit
(Yes, it is a military kit)

Setting up a sterile field

Making an incision
Practicing her knots
This takes a lot of concentration!
Finishing off


  1. Excellent blog post. I practice on oranges. I think I'll get some pigs feet from the butcher and try that next.

  2. I greatly admire Maid Elizabeth's desire to serve others. She is, indeed, an asset to her community and to others.

    As for suturing, I am afraid I would pass out and become another casualty if I attempted it. I'll stick to using Steri-Strips. My advice, if somebody needs stitches, please get injured far away from me...for your own sake (and mine). :}

    NoCal Gal

  3. A tip. The fingers in the second picture are incorrectly placed. There should be a space between the second and middle finger. The needle track should be centered on this space. Sometimes the needle is harder to push through and can give suddenly, causing a needle stick to the caregiver.
    If the patient is uncooperative (think head injury or woman in active hard labor) instead of fingers you should use large forceps (turned on edge so the needle goes through the space) to hold the position. It's harder to get it "just right" but safer. HIV is not easily transmitted this way but Hep B and C are. Old Timer

  4. Without basic training at the least, most of us should not try suturing a wound. Irrigate well and steristrip. Do not forget the irrigation. The solution to pollution is dilution. You don't want to close a wound on icky stuff and invite infection. If you have no sterile wound wash, just drinking water, in generous amounts, will do better than no wash.

  5. I'm curious, where is she getting her training in suturing? Has she taken a class or is she learning from a manual?

  6. Anonymous 1/11/11, 3:02pm
    You inspired me to acquire some bottles of wound irrigation. They are merely saline solution - sodium chlorite (if I remember correctly) and each cost $6.49 on sale at a major (chain) pharmacy.

    Would not putting some sea salt into a bottle of water and shaking vigorously do just about as well? I ask because, whenever possible, I like to learn alternative ways to accomplish the same things. Thanks.

    NoCal Gal