Welcome to Major Trauma, my name is Master Myra VanIsle, and I am a Lore Keeper Emeritus and Senior Healer specializing in Pathology, Mending, and Communing. This course will focus on providing students with a cursory understanding of severe life-threatening injuries that are no longer ambulatory.
We will cover how to help those with life-threatening injuries, treat shrapnel wounds and major burns, and use cauterization and suturing to help heal the patient. We’ll also discuss the importance of quick and effective action when treating major trauma.
Sutures
Sutures are a type of medical treatment that involves stitching a wound or cut closed. Sutures help promote the injury's healing and reduce the chance of infection. There are several different types of sutures, including absorbable and non-absorbable sutures. Non-absorbable sutures are usually made of cotton or nylon and must be removed by a medical professional, while absorbable sutures dissolve on their own over time.
One of the oldest, most reliable methods when treating wounds is sutures. Suturing is the process of stitching or sewing together two edges of a wound with a thread and needle. To ensure the best outcome, it's essential to properly prepare the wound beforehand by disinfecting it, irrigating it to remove any debris, and then applying a salve or antiseptic to protect it from infection. Depending on the depth of the wound, an anesthetic may also be applied topically or injected in the area.
There are several different techniques used when stitching a wound with sutures.
Simple interrupted sutures involve making single stitches that are not overlapping and can be used in areas with a bit of tension. A continuous running suture involves consistently stitching the wound. This technique is usually used in areas with less tension, such as the face or abdomen.
Continuous sutures involve a series of stitches that use a single strand of suture material. The suturing process is started at one end of the wound, and the suture material is looped back on itself, creating a continuous pattern along the wound. Continuous sutures can be used in areas with less tension, such as on the face or abdomen. The advantage of this method is that professionals can complete it relatively quickly, which is beneficial in emergencies.
The running subcuticular suture is another common technique used by medical professionals. This involves continuously stitching the wound beneath the skin's surface. This technique is often used for cosmetic purposes, as it leaves no visible scarring and is also beneficial in areas where tension can be an issue. Furthermore, the running subcuticular suture is secure and helps reduce the risk of infection, as the wound is not exposed to the air.
The purse-string suture is a unique technique that involves gathering the wound's edges together with a circular stitch. This technique is often used to close incisions in areas requiring higher tension levels, such as the perineum or anus. The purse-string suture is strong and secure, ensuring the wound's edges remain in place while promoting healing. It is also beneficial in preventing infection, as the wound is closed.
Buried sutures involve stitching the wound closed beneath the surface of the skin. This technique is often used in areas where there is very little tension, as the sutures are held in place by the surrounding tissue. This technique is beneficial in preventing infection, as it keeps the wound closed and away from the air. Additionally, buried sutures can increase the strength of other sutures, as they help hold the wound together while healing.
Deep sutures close deeper layers of tissue beneath the skin's surface. This type of stitching is beneficial in ensuring that the wound heals properly and securely. Deep sutures are used in areas with significant tension, and they help reduce the risk of infection by providing an additional layer of security. These sutures are usually left in place, except in cases where the sutures need to be removed due to infection or other complications.
In addition to the various suturing techniques described above, medical professionals may use adhesive strips, staples, or glue to close a wound. These methods are generally used in areas where there is not a lot of tension, such as on the face or abdomen. The advantage of these methods is that they are quick and easy to use and can help reduce the risk of infection. The downside of these methods is that they are not as secure as traditional sutures and are not recommended for areas requiring higher tension levels.
If a wound is too large to be stitched, memory plastics may be used as a substitute for either synthskin or a skin graft. This material retains its form and will naturally dissolve within a week when given the proper care, including keeping the area clean and germ-free. Afterwards, bandaging the wound is critical to ensure that it heals properly. Sometimes, combining memory plastics and bandaging may yield the best results.
While memory plastics effectively treat open wounds, it is essential to remember that the material is not intended for use on broken bones. Memory plastics are also not recommended for wounds bleeding heavily or with a large amount of inflammation. In these cases, a more medically-advanced solution may be necessary to treat the problem correctly. Additionally, unlike other materials, memory plastics are not designed to last for an extended period, so it is crucial to monitor the wound and reapply the material as needed.
Shrapnel
Shrapnel is an incredibly common wound in wartime, and as a healer, you will likely have to treat it at some point during your career. The most critical steps in treating shrapnel wounds are to control external bleeding. It is essential to prepare the treatment area. To do this, first, place surgical towels under the area around the patient and around the treatment area. This will help to protect the patient from any debris that may come off during the treatment. Then clean the wound, and inspect for any residual fragments that may be causing further damage. Use a cauterization pen to seal open blood vessels, then disinfect and rinse the treated area again. Once you have finished the treatment, properly dispose of the debris and medical waste. Finally, it is essential to monitor the patient for signs of infection, as well as for signs of shock. Covering the wound with a sterile dressing is also necessary to prevent further infections. If essential, administer antibiotics and ensure the shrapnel wound is properly cleaned and treated. Remember that a shrapnel wound is more prone to infection than other wounds, so it is essential to be mindful of the patient's overall health. If a patient does develop a disease, be sure to provide them with a course of antibiotics to help clear it up.
Burns
Burns are another common injury in wartime and can range in severity from minor to primary. It is important to sedate the patient first for significant burns, constituting between 10% and 30% of the body. As with shrapnel wounds, these are only treatable by a trained healer and require specific precautions to help the patient heal properly. After sedating the patient, the affected area must be disinfected with antiseptin-D and rinsed. Use forceps to clear away any dead skin or debris in the wound, and then rinse again. Liberally apply burn salve or whatever topical medication is indicated, and finally, dress the wound. Remember that while topical treatments can help reduce pain, they will not reduce the severity of the burn or speed up the healing process.
Synthskin
For more serious major burns, a translucent sheet of kolto known as Synthskin can cover the affected area. This synthetic material provides a protective barrier while promoting the healing of the wound to heal naturally. Synthskin encourages healing and helps reduce the scarring that can occur with severe burns. It also helps prevent infection, as the synthetic material is breathable yet waterproof.
Burn Salve
A burn salve is a thick blue gel that forms a firm seal over the burn area. It helps to protect the wound from contaminants, preventing infection and promoting healing. As with shrapnel wounds, it is essential to be mindful of the patient's overall health and provide antibiotics if necessary.
Force Healing
Now, the caveat here is that after using the cooling salve, Force Healing can promote quick healing of the burn to repair any damage, without which you are left with slower natural healing through Synthskin. Advanced Force Healing is effective in quickly healing both minor and significant burns and can be used in conjunction with Synthskin to promote faster recovery times. However, it should be noted that Advanced Force Healing should only be used when necessary, as healers can only heal so much before exhaustion. Additionally, a trained healer should only use Advanced Force Healing to ensure that the patient is safe and that the procedure goes smoothly.
Ultimately, it is essential to remember that treating shrapnel wounds and burns is a delicate and careful process. As the healer, you are responsible for using the proper techniques and procedures to ensure that the patient heals quickly and thoroughly. Be sure to monitor the patient during their recovery, and provide antibiotics or additional treatments when necessary.
Mental Health
Finally, it is essential to remember that treating shrapnel wounds and burns requires a delicate balance of physical and psychological care. It is necessary to provide the patient with a safe, comfortable environment to help them heal, as well as to provide them with emotional support. To ensure the best possible treatment, the patient amust be calm and relaxed during the healing process.
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