Monday, February 3, 2014

Series Post: Ask Dr. Dina - Sutures

DISCLAIMER: I am not a doctor, nor do I play one on TV. I do not hold a current medical license or certification (I let them lapse because I no longer work in the medical field and don't intend to ever again). What I do have is an extensive medical background in various fields. Everything you read here is the result of either education, training, research and interpretation, or personal experience. The information in this post is not to be taken as a substitute for professional medical advice or examination. Seriously, if you're having an immediate medical problem and you're reading this blog for help, get off the damned computer and call an ambulance!

So, I've been doing this "Ask Dr. Dina" series for about a year now. We've talked about a lot of things medicalish to do with your writing, and today I want to talk about an aspect of wound care that really bugs the fuck out of me when I see it done improperly. As in, I will scream "YOU'RE DOING IT WRONG!" at the TV/book/movie, whatever. Incidentally, theater staff doesn't like it when you do that.

I talked last summer about cuts and punctures. Today I want to talk about sutures.

What are sutures, you might ask? Well, that's the fancy medical speak for "stitches." (Staples are different. Those are a different material used to close a wound, while stitches is the name of the actual process involving sutures. It's complicated.)

Now, you generally only need a wound closed ("need stitches") when that wound is over ¼ inch deep (you can sometimes see fat or bone in these cuts), somewhere on the body that moves a lot or is very elastic (like the face or hands), or is really long (about an inch or longer). Here's a great resource for questions (pay no attention to the hippy behind the curtain).There are always exceptions, though, so if you've got a wound that bleeds for over ten minutes despite holding direct pressure over it or is in a place where the edges won't stay closed with a bandage, go to the emergency room/get help. Always play it safe. It's better to get something looked at than ignore it.

Now, having said that, let's talk about what drives me nuts.

It drives me absolutely batshit when I see someone in a movie/TV show/story getting stitches and then the person doing the suturing cuts the suture with their teeth.

First of all – NO.



Am I making myself clear, here?

Now, unless said character is using an actual sewing needle and cotton thread (like in the Thomas Jane version of The Punisher) to sew someone up, breaking suturing material with your teeth is stupid for several reasons –

1) suture kits come in sterile packs with SCISSORS RIGHT IN THEM. See?

If there are scissors RIGHT THERE and your character uses their teeth to cut something instead of those, put your fucking pen down and go to your room and think about what you've done. Stop trying to look cool with your faux-badassery (hint: there's nothing badass about chomping on sutures) and write the scene properly.

2) most sutures are made of a polymer material (polyglycolide), which in layman's terms pretty much means FUCKING PLASTIC. Most are braided/more than one strand and are designed to be tough/not break, so you might be chewing on them for a bit. There are some sutures that are a little more flexible (like silk for certain wounds), but for the most part, you're getting fucking plastic cord, okay? It's not just going to snap because you bite it once.

3) HELLO HIGHLY UNHYGENIC. You just cleaned the wound. You're spending all this time closing it up, and now you're going to put your nasty-ass mouth RIGHT NEAR AN OPEN WOUND YOU JUST CLEANED AND GET YOUR SLOBBER ALL OVER THE NICE STERILE SUTURES YOU JUST PUT IN? Are you fucking KIDDING ME? (Again, if you're using actual sewing needle and cotton/whatever sewing thread, you're really not caring much about sanitation here, so I'll technically give you a pass, but SERIOUSLY? COME ON!) The human mouth is one of the filthiest places imaginable. Don't put sutures in your mouth! No, not even the end bit!

These are just a few reasons why you shouldn't have your characters do this. I could go on, but you get the idea. DO NOT DO THIS. If I catch you doing this stupid shit in your writing, you and I are going to have words, then I will give you something that will result in you getting to experience firsthand how sutures are properly done.

Questions about medical issues with your writing? Leave them in the comments below and I'll get back to you as soon as I can. (THESE MUST APPLY TO FICTIONAL SITUATIONS ONLY. I AM NOT YOUR DOCTOR, NOR A SUBSTITUTE FOR ONE.)


  1. OH OH I KNOW THIS ONE. And irrigate the wound. And you have to stitch up within a certain time frame. And you start in the middle of the wound and work your way to the end. And it hurts like a motherfucker.



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