sutured infection

werewterrefgrin  asked:

You mentioned in a post that wounds shouldn't be stitched after 24 hours; why is that? Are there any exceptions?

You know, I can’t find a good resource on exactly why this can be detrimental?

My preliminary research goes like this: if a wound is going to become infected, that infection usually takes 24-72 hours to show up. Within that first 24-hour window, it’s safe to close the wound (sutures, liquid stitches, staples, whatever), because the bacteria haven’t taken hold (unless the wound is majorly contaminated). The very last thing we want is to suture a bacterial infection into a wound, underneath a closure, where the bacteria can just eat away at the tissue below. Limbs are lost doing things this way.

There doesn’t seem to have been a lot of research, but the best sources I can find say that most wounds can be safely closed in the first 18 hours (24h+ on the scalp).

If that timeframe has passed, the wound will be left open, dressed, and left for “secondary closure”–letting it heal on its own. For high-risk wounds (such as animal bites) that present, even within the 18 hour window, an approach called tertiary closure is used, where the wound is left open (secondary closure) for a few days to insure there’s no infection before stitching it closed (primary closure).

Wound care is an area that I’m embarrassingly weak in, actually. Believe it or not, the first goal I set up on the blog Patreon account is $200/month for textbooks (we’re 10% of the way there!), with wound care and orthopedics being my first-round-draft textbooks to nab.

HOWEVER, this ask is making me consider a post on different types of wound closures, which is good. It’s always nice to have inspiration now and again :)

Thanks for the question, @penstgrin . Good luck with your stories.

xoxo, Aunt Scripty


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