Daniel Keyes
November 9, 2006

Imagine yourself stranded on an uninhabited island in the woods, the sole survivor of a plane crash. You have deep gash on your leg from the crash that appears to need stitches. What do you do now?

The first step in a situation like this, says Dr. Deepti Pasricha, a physician at Markham Stouffville Hospital, is to stop any bleeding by applying pressure to the wound with your hand. Dr. Pasricha recommends cleaning the wound well with water and using an anticeptive if possible. You shouldn’t have trouble finding water on an island.

The next task is finding a needle and thread. But if you don’t know where to look it’ll be like trying to find a needle in a haystack (or in a pile of plane rubble). Dr. Pasricha says that many first aid kits are equipped with a suture – that is, a small curved needle attached to a nylon thread used for stitches. If you can’t find a suture in the plane’s first aid kit, an ordinary needle and thread will do; check the luggage for sewing kits.

“Always make at least three stitches,” says Dr. Pasricha as she takes out a suture – a snake, with a needle head and a long thread body – from its paper packaging, preparing to demonstrate how to stitch the “wound” between two napkins lying side by side on her examination table.

With the neck of the snake between her thumb and index fingers, she pushes the head down through one of the napkins, about five millimetres from the wound, and then pokes it back up through the other napkin, again, five millimetres from the wound. With the tip of the head exposed on one side of the wound, she grabs it and pulls until about a thumb-length of the tail is left at the other side. “The painful part for the patient is over,” she says.

Holding the head with her left hand, she wraps the snake twice around the thumb and index fingers of her right hand, which pinch the air. With those same fingers, she grabs the tail and lets the coiled body slide off her fingers and constrict around the tail as she pulls the head as far as it will go. The result is a tight knot holding the two napkins together, but she repeats the process two more times for re-enforcement. Finally, she trims the excess thread and the stitch is complete.

With Dr. Patricia’s instructions, stitching yourself up the next time you find yourself stranded on a wooded island with a gash on your leg shouldn’t be a problem. Escaping the island is another story.