MEDICAL Q: Do I always need antibiotics after stitches?

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    • #91650
      Corvette
      Participant

        Stitched up my foot on Monday w/ 5 stitches (dont ask) :wacko:

        A medical provider at work, and a doc-in-the-box told me I should take antibiotics just in case and wrote me a script.

        I rather save the antibiotics for just-in-case later (you know like prepping) ;)

        I do have a little swelling and pain today but no discoloration.

        Can I wait and see if slathering the stitches w/ NeoSporin keeps it down.

        What do you guys think?

        Is it safe to wait another 24 hrs to see if I have signs of infection before I shoot a full treatment of A/B on this?

        Or ?

      • #91651
        Joe (G.W.N.S.)
        Moderator

          Yes, it is reasonably safe to wait.

          I have given myself stitches many times and have never given myself antibiotics just because.

          Shoot, half the problem we currently have with antibiotic resistance is due to this mentality.

        • #91652
          Corvette
          Participant

            I agree I also avoid use of AB as much as possible. :good:

            What worries me a bit I have some pain surrounding the area of the actual injury /stitches, not just at that spot… :unsure:

          • #91653
            Max
            Keymaster

              Speaking as a medical professional, hopefully your tetanus titer is up to date.
              That said, I seldom use any antibiotics for common skin cuts. I clean it real good with peroxide, maybe apply a bit of beta-dine. And monitor. If it becomes painful, swollen, red or hot it needs to be opened, drained and cleaned again.
              So hang on to the abts. Keep in mind that different abts are used for different infections and one that works good for a skin infection usually won’t help with pneumonia. The exception being cipro which is good for skin, lung and bladder infections.
              One other thought, veterinarian abts are the exact same as human abts and you can order them on line if you are thinking that you need to stockpile some.

            • #91654
              Corvette
              Participant

                I just got a tetanus booster 4 months ago :)

              • #91655
                Joe (G.W.N.S.)
                Moderator

                  Was it a clean or ragged cut?

                  Any chance of debris of some sort left behind in the wound?

                • #91656
                  Corvette
                  Participant

                    ragged
                    It was cleaned out real well w/ H2O2, I did not do this by myself :whistle:

                  • #91657
                    Max
                    Keymaster

                      That redness in the surrounding area might be infection if the wound wasn’t cleaned good enough, but it might only be a histamine response from the body’s injury reaction.
                      Try taking a dose of benadryl and see if it improves any.
                      If it gets notably worse you will need to go to the ER to have an xray done. You do not want necrotizing fasciitis. (flesh eating bacteria) which is a staph infection gone wild.

                    • #91658
                      Joe (G.W.N.S.)
                      Moderator

                        A ragged cut will of course have a broader pain field.

                        Depending how injured, was it deep enough to possibly damage bone?

                        This could add to the pain.

                        Keep an eye on it, but remember most people get staph from hospitals, not home or in the field.

                      • #91659
                        DuaneH
                        Participant

                          As you say F: It’s all in the nuances. I can’t answer your question with good information without knowing the 5 W’s of the situation.
                          Me personally: For a shallow, clean cut I typically don’t use abx. Just clean it with soap and water and a good flushing with sterile water. (NOT H2O2). Then some Neosporin.
                          For deep and dirty cuts: Absolutely will use them.

                          In between? It depends on the nuances..
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                          As far as abx go: Naturally I have a good supply, but since I am on Tricare right now I can’t get bulk quantities paid for by Tricare. So I have to pay out of pocket for them.
                          Guess what I buy for bulk? Thomas Labs fish abx. They are US mfgd, USP generic, human grade abx repacked into bottles labeled for fish.
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                          http://www.advancedtissue.com/3-ways-know-difference-healing-infected-surgical-wounds/
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                          Keep in mind that until the 1920’s there was no such thing as abx and people were stitched up all the time. Mortality rate…? Hmm.

                        • #91660
                          Roadkill
                          Participant

                            Agree with DH. No H2O2. Just soap and water and scrub it well. I also like steri strips and super glue.

                          • #91661
                            wheelsee
                            Participant

                              Depends……vast majority of “simple lacerations” do not require antibiotics (abx)……we irrigate the heck out of with sterile water or normal saline (NS), at least 250 ml, then close it up……..haven’t used abx ointment in years…..cover it for 24-48 hours then let it dry…..keep clean and dry…….

                              “Complex lacerations” – whole nother story, including puncture wounds, animal bites, and lacs received while in filthy environment, I.e. plumbers, sanitation workers, farmers, etc (case-by-case)

                              Disclaimer – not to be construed as medical advice, just my “observations” from the ED

                              BTW, be sure tetanus-diphtheria is up-to-date (10 years without injury, 5 years with) and CDC recommends a Tdap (tetanus, diptheria, pertussis) once as an adult due to increased incidence of whooping cough (pertussis)…….also understand the difference between redness of infection and mild redness (bad term, I know, maybe “hint of redness” ?) inflammation due to trauma and the healing process

                            • #91662
                              HiDesertRat
                              Participant

                                Keep an eye out for purulent drainage, greenish or yellowish, foul smell, check to see if tissue is remaining pinkish. If there is a lot of whitish or obviously dead tissue, in all likelihood you will need to seek some further attention, debridement etc. Keep it elevated and change dressing when needed. Neosporin or similar is good. No more peroxide, it kills good tissue. It comes 3% solution and always diluted before use during initial clean up. Serosanguineous drainage ie blood mixed with plasma like clear fluid ok. Might want to check your temp periodically and see if you are febrile, although more than likely you will be elevated, but if you go into 100’s and higher, again, go seek medical evaluation. Martinis and aleve work well for pain also, shaken not stirred.

                              • #91663
                                Max
                                Keymaster

                                  Exactly why I do not like stiches. smother that cut with honey, butter fly bandage, cover with small dressing, clean as need. my 2 cents.

                                • #91664
                                  DiznNC
                                  Participant

                                    I know a somewhat famous prepper who tried to do the same thing you’re doing. He leg got infected and gave him a real scare. I’d say don’t skimp on the antibiotics. You can buy a shit load of that stuff these days as fish care products.

                                    Oftentimes those stitches introduce shit into you by the needle punctures. That’s why lots of folks are using alternate closure methods these days.

                                    If it was me , I wouldn’t fuck with it. Take the antibiotics.

                                    And call me in the morning.

                                  • #91665
                                    DuaneH
                                    Participant

                                      There are issues with using butterfly bandages. The principle of use with sutures and butterfly bandages is approximation. That means that the edges of the wound are placed together in order to promote healing. With a superficial wound, butterfly bandages are fine; however, if the wound goes deeper then using BFL bandages will only approximate the upper layer of skin potentially leaving a gap in the deeper layers. It takes longer to heal and MAY be a place where infection can occur.
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                                      Another thing to keep in mind is that in a grid situation, we may be at higher risk for infection that we are now. Lowered immunity d/t poor nutrition or fatigue. High risk of exposure to diseases d/t prevalence of diseases and/or living in a dirty situation. Bathing every day goes a long way to preventing infections. What happens when we can’t?
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                                      So don’t underestimate the importance of ABX.

                                    • #91666
                                      Corvette
                                      Participant

                                        Alright I staring taking them, stuff is still kinda painful when I feel it should have calmed down by now.
                                        Mainly I dont want to risk any excessive debilitation for the coming MVT weekend.
                                        Its bad enough that this will be the 3rd time in only 6 months that I will show up to MVT injured or sick. sigh :wacko:

                                      • #91667
                                        Corvette
                                        Participant

                                          Alright I am taking the antibiotics and they are giving me the you-know-what.

                                          sigh…

                                          My foot is feeling fine I only been dosing for 2 days I think its safe to just stop. Its not like I had an infection….

                                          Comments?

                                        • #91668
                                          Joe (G.W.N.S.)
                                          Moderator

                                            The main problem is if you have any infection whether minor or not is partially killing it then stopping could lead to a more difficult problem.

                                            Generally speaking once you start, it must be finished or replaced with an alternative one.

                                            Best advice I have is to finish it, but I am just a gifted amateur! :yes:

                                          • #91669
                                            Corvette
                                            Participant

                                              Ok a little update for those who are at all curious.
                                              I forgot the stuff at home when I went to MVT and so missed 2.5 days of doses ( as well as strating late by 2 days)…

                                              Sooooo…. my foot is actually now quite swollen and has some discoloration and the location is still quite painful.

                                              Its obvious its been infected.
                                              This really surpsied me since apart from the occasionla workout injury I never need a Doc.

                                              Stuff that would get others sick often would not affect me at all. so I was surprised this happened.. so went to a doc-in-a-box today
                                              and for a new prescription and a shot of antibiotics into the ass.

                                              I also tried to recruit the doc for an MVT class :D

                                              Also this illustrates once again how utterly important it is to try not to get cut in the first place.

                                              has anyone ever noticed how in nature very rarely is anything really sharp?
                                              Thats why human skin works so well in such an environment… but Human skin is not designed to protect you against the what a artificial human environment can create

                                              people are so used to not being threatened by minor cuts … not wanting to be dramatic but if this was grid down bad things might be underfoot now…

                                            • #91670
                                              Joe (G.W.N.S.)
                                              Moderator

                                                people are so used to not being threatened by minor cuts … not wanting to be dramatic but if this was grid down bad things might be underfoot now…

                                                If working with a team it is important to report any injury no matter how minor to your “Doc” (you need one, even if just an amateur) it could be life and death post event.

                                              • #91671
                                                gramma
                                                Participant

                                                  Don’t forget the probiotics (or just eat yogurt a few days) to put some good bacteria back in your stomach. Antibiotics can wipe out enough to cause secondary problems, in some people.

                                                • #91672

                                                  Just saw this string. First thing that comes to my mind about abx decision process is history. Duane mentioned the w’s. How and we’re the F did the cut occurr?? Not just where EXACTLY on the foot is the wound but where was the foot? I stepped barefoot on a sterile scalpel blade vs I stepped on a decomposing coyote carcass and a rib stabbed thru my shoe into the bottom of my foot. Big difference.

                                                • #91673
                                                  DiznNC
                                                  Participant

                                                    Yeah this is a good one. Context is huge. I have had numerous cuts from clean knife blades that never needed anything but closure. I also had numerous simple scratches from thorns n stuff in the jungle which festered within 24 hours.

                                                  • #91674
                                                    Corvette
                                                    Participant

                                                      Sorry to hear about the O.P.’s foot and hope all is well now.

                                                      That said — this thread, with the comments and pt updates over the course of a week, is pure gold for use as a case study in at least 3 different medical topics. Saved.

                                                    • #91675
                                                      gunnerbob
                                                      Participant

                                                        Agreed, this thread is a great source of information.

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