Coastal Oregon as a Retreat Locale, by LongJim

Years ago, as a young man, I was impacted by the 1970s gasoline crisis, making for long gas station lines and the accompanying angst, which was preceded by a few years by a strange  market-driven meat-shortage. I remember that episode resulted in ground beef prices soaring,  and even companies coming out with “textured soy protein” mixes in cartons as a substitute. That series of events probably steered me into the emerging survivalist-prepper culture, and ever since then, I’ve always had a full pantry of tuna, beans, bullets, and water wherever I went. I carried that mindset over to my career in law enforcement, by keeping a case of MREs in my patrol car trunk, those courtesy of the U.S. Forest Service fire crews, who rotated them out and into my care, from time to time. I worked in the California high country, with a large portion of Yosemite National Park in our county, and thousands of acres of wilderness to rescue “tourons” [“tourist morons”] from their ignorance-predicated calamities. We also had our share of small airplane crashes, and a couple of brushes with serial killers, kidnappers, and bank robbers, who thought the remoteness made for a good hiding place. I was active as a Range Master, and Tactical Team leader, and added skills learned while participating in those training regimens to my tracking, and woodsmanship experience growing up in the rural american southland.  A job-related injury, and development of PTSD, led me to retire somewhat early on a partial disability, and I started working in the medical field, adding even more knowledge and skills to my prepper base.

Dissatisfied with the anti-gun and liberal political environment in California,  I moved to the elk and salmon saturated serenity of the Pacific northwest coast. I am active in the local CERT program, and my wife is a county law enforcement officer. This area is well suited for my brand of prepping, as the ocean water  temperature of mid-50s, moderates the daily air temps throughout the year. For example, the winters  are very mild, although windy and rainy, yet we rarely get frost, icy roads, or snow.  In fact, wood stoves,  or wall space heaters are the norm, and nobody I know has an air conditioner as the summer daily temps are upper 60s to near 80. The grass needs to be mowed almost all year round, and though it requires short-growing season hybrid tomato sets for that crop, cole, potato, cruciferous, and root crops flourish with the addition of “hoop-style” plastic covered hot house-type gardens year-round. If you want temps a bit warmer, simply relocating inland 5-to-8 miles produces daily summer temperature lows of the upper 40’s to highs in the 80’s. Winter temps are comparatively in the mid-south range, with occasional light snows, and mid-40s highs. Water is not a problem, as the winter and spring provide an abundance of rain water for collection and storage, yet the summers are warm, mild and dry.  Fishing, and hunting are a huge part of the culture, and many duck hunt, smoke salmon, venison or game , and families have an elk camp, or tradition of deer hunting, clamming or halibut fishing as well.  Firearms laws are fairly generous, Oregon is a “shall issue” state for concealed carry, and there are  no restrictions on high-cap magazines, permitted suppressors, or full-auto/select fire semi-auto rifles.  Open carry is permitted, and I see folks packing on occasions, more so especially the farther east one travels in the state.

In my particular area of the central coast, the “golden hordes” would have to have a full tank of gas to get here, and I believe the local sheriffs policy would be to secure the roads into the county with check-points, and “hunker down”. The roads coming into the area run through many miles of wilderness, and the entry points are down to two, from the east, and one each from the north and south. The Pacific coast itself is a rugged barrier to the west. This area has mountains running down to the seashore, and earthquakes and related tsunamis would affect us only minimally mainly with potentially taking out one main coastal north-south bay bridge, but there are other alternate routes in that locals know and would use in that case. Our house sits at near 200 feet of elevation, and I can drive 5 minutes and be 1,000 feet higher.  There are no potential megavolcanoes in our back yard, unlike the areas around Yellowstone, although the northwest does have numerous dormant an one semi-active one, and we are far away from any ash or nuclear bomb-generated wind-blown radiation paths.

Living here, with all of my neighbors with  whom I’ve dialogued about a SHTF scenario being on-board the “hunker-down and watch each others back” plan, we can survive quite well. I can supply my household with plenty of fresh water, walk 200 yards down the hill to the beach, gathering blackberries,and by fishing,  foraging for shellfish, or Dungeness crab,  come home every day with food for my family and neighbors. If I choose to bug out, my trailer is stocked and numerous gravel roads shoot off into miles of forest less than five minutes from my front door. I believe that in a TEOTWAWKI scenario, the fishing industry here will be a source of food, trade, and an economic boon, after a Dollar crash, supplying those items to the rest of America, along with firewood and hydro power. Back to the local CERT teams, operated by each local fire department, they are all tied in to the county-wide EMS structure which is a fine-tuned, well-oiled and managed system. They train constantly, and have ham-backups for any comm. breakdowns, or power outages. If you join them and take the training, you are issued a “kit” with vital handie-talkie radio, and emergency equipment, valuable in a TEOTWAWKI scenario, and you are “in the loop” for intel and supplies if that happens.

As to the power grid issue, the northwest’s power is almost totally generated by dams on the Columbia River, and are well maintained and should continue running in most scenarios. Unlike my experiences with the reliability of electric power in California, and West Virginia, I’ve yet to have a storm knock out the power in any home I’ve lived in here for more than a ‘flickering” moment in the past 9 years! Wind affords many hobby-opportunists the ability to generate power virtually year-round, and I’m working on that project accumulating the parts for a windmill/battery bank set-up. [JWR Adds: With photovoltaic panel prices still falling to below $1 per watt, I do not recommend wind generators for anyone living south of the Arctic Circle. They are just too expensive, have low, sporadic yields, and most of them are mechanically unreliable.]

My wife and I have participated for many years in cowboy action shooting, and I have a complete reloading set-up for many pistol and rifle calibers, along with a supply of bullets, primers, shot, and powder for use and barter. So, in wrapping up my picture of the Oregon coast as a great prepper location, let me say I’m surprised that it’s not included in recommendations for preppers to relocate here along with “American Redoubt” areas of Idaho, Eastern-Washington, Eastern-Oregon, Wyoming, and Montana.

This truly is God’s country, and he has blessed us in living here, with a land of bounty and protection. I’m not saying that I’ll be eating Dungeness crab and baked potatoes while I hunker down by my wood stove post-TEOTWAWKI, but I can virtually guarantee that my family and neighbors will have plenty of water, heat, shelter and food that living elsewhere, even in the much-touted “Redoubt”, would come only with much more struggle and effort.



Letter Re: An Indiana Disaster Preparedness Meetup Site

Hi Mr. Rawles,
To start, your site has been an inspiration to many people, myself included.  I am a firefighter here in Indiana and what I’ve noticed is there are so many different places to get info, some good some bad, but it is tough to get some centralized information for local training’s.  We started a Meetup group in Central Indiana that is growing fast and it is not a monetary site or a forum, just a centralized place to post training events and meetups around the area.  You are one of the main sites we encourage all of our members to go to for Internet Information and News.  We do not profit at all will list any businesses as a site sponsor for free.  Thanks for your help and thanks for your awesome site.  -W.A.



Economics and Investing:

J.B.G. sent: Five years on, the Great Recession is turning into a life sentence

Parallel currencies! Coinage Act of 2012 – Congressman Ron Paul

R.B.S. sent a link to an interesting Numismaster piece: Fake Silver Rounds Can Cause Real Problem

Items from The Economatrix:

Growing Paychecks Boost Americans’ Buying Power

Fed Can’t Fix US Economic Headwinds

Bill Haynes:  We Are Now Seeing Huge Orders For Physical Gold & Silver

African Nations Chase Out The Almighty Dollar



Odds ‘n Sods:

Joshua E. mentioned that Savage has resumed making a .22LR/.410 shotgun combination gun, the Model 42. This a a very practical little gun for pest shooting or foraging.

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A new blog with some real merit: Prepography.com

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A reader mentioned: “A collection of YouTube videos focused mostly on how to have fun making or doing things on your own for little or no money”. His latest video on how to make a flea trap is brilliantly simple.

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Charley S. sent this, just for fun: “So papa, how do you like the iPad we got you?” No need to understand the language to get it…

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F.J. spotted this hint: Use an Old Gift Card to Keep a Bit of Duct Tape With You at All Times



Jim’s Quote of the Day:

"In contemplating the political institutions of the United States, I lament that we waste so much time and money in punishing crimes, and take so little pains to prevent them. We profess to be republicans and yet we neglect the only means of establishing and perpetuating our republican forms of government. That is, the universal education of our youth in the principles of Christianity by the means of the Bible." – Benjamin Rush, “A Defense of the Use of the Bible as a School Book”, 1798



Notes from JWR:

Just released! The latest sci-fi novel in the popular Freehold series by SurvivalBlog’s own Michael Z. Williamson: When Diplomacy Fails. This novel is another prequel to Freehold, involving the Ripple Creek crew. Here is a summary: “Alex Marlow and Ripple Creek Security’s best personal security detail return to action. This time, they really don’t like their principal, World Bureau of State Minister Joy Herman Highland–a highly-placed bureaucrat with aspirations to elected office. Even worse, Highland’s assistant wants to publicize every movement and action for her boss’s pending campaign, which is anathema to good security. With a person of this status, it’s not a case of someone wanting her dead. The only question is how many people want her dead, and what are they bringing to the fight? The enemies are from without, within and all over. They have resources, funding and political cover. Ripple Creek needs to be cautious. But the enemy also needs to worry. They’re going to be getting in each others’ way in the process of carrying out their plans. And Ripple Creek has no qualms about explosions on galactic news. In fact, they enjoy it.”

OBTW, Mike did mention this caveat: “The novel contains some plot-relevant sex, violence and torture, as well as language.  It is not recommended for young readers.”

Today we present another entry for Round 42 of the SurvivalBlog non-fiction writing contest. The prizes for this round include:

First Prize: A.) A gift certificate worth $1,000, courtesy of Spec Ops Brand, B.) A course certificate from onPoint Tactical. This certificate will be for the prize winner’s choice of three-day civilian courses. (Excluding those restricted for military or government teams.) Three day onPoint courses normally cost $795, and C.) Two cases of Mountain House freeze dried assorted entrees in #10 cans, courtesy of Ready Made Resources. (A $350 value.) D.) a $300 gift certificate from CJL Enterprize, for any of their military surplus gear, E.) A 9-Tray Excalibur Food Dehydrator from Safecastle.com (a $300 value), F.) A $250 gift certificate from Sunflower Ammo. and G.) A $200 gift certificate, donated by Shelf Reliance.

Second Prize: A.) A Glock form factor SIRT laser training pistol and a SIRT AR-15/M4 Laser Training Bolt, courtesy of Next Level Training. Together, these have a retail value of $589. B.) A FloJak FP-50 stainless steel hand well pump (a $600 value), courtesy of FloJak.com. C.) A “grab bag” of preparedness gear and books from Jim’s Amazing Secret Bunker of Redundant Redundancy (JASBORR) with a retail value of at least $300, D.) A $250 gift card from Emergency Essentials, and E.)Two cases of Meals, Ready to Eat (MREs), courtesy of CampingSurvival.com (a $180 value) and F.) A Tactical Trauma Bag #3 from JRH Enterprises (a $200 value).

Third Prize: A.) A Royal Berkey water filter, courtesy of Directive 21. (This filter system is a $275 value.), B.) A large handmade clothes drying rack, a washboard and a Homesteading for Beginners DVD, all courtesy of The Homestead Store, with a combined value of $206, C.) Expanded sets of both washable feminine pads and liners, donated by Naturally Cozy. This is a $185 retail value, D.) A Commence Fire! emergency stove with three tinder refill kits. (A $160 value.), and E.) Two Super Survival Pack seed collections, a $150 value, courtesy of Seed for Security.

Round 42 ends on September 30th, so get busy writing and e-mail us your entry. Remember that there is a 1,500-word minimum, and that articles on practical “how to” skills for survival have an advantage in the judging.



Do-It-Yourself Rocket Stoves, by E.B.

I live and prep on a tight budget – at least for the time being. I am lucky to have a fireplace in my home, not a woodstove, nor the room for one, but at least a fireplace. It’s better than no fireplace, but rather inefficient for heating or cooking. It would do in a pinch, but a rocket stove would greatly reduce the amount of wood needed to cook a meal. On my budget even $100 is a lot right now and I began looking into building my own rocket stove. The knowledge is out there, and “improved stoves” are being made in many third world countries to reduce fuel use and increase efficiency. The number of sizes, shapes and applications for improved stoves is incredible. I decided to try to make my own, and the money I saved could then be spent on something I couldn’t make for myself (like ceramic water filters, for instance).

Why DIY?
There are some very good reasons why learning to do-it-yourself (DIY) with an improved stove is a good idea. Not least of which is the cost. Cost was the initial factor for myself, and remains a benefit for me. Not only can I make myself low-cost rocket stoves, I can make them for extended family members and gift them as emergency kits disguised as camping stoves. In learning how they operate, you can also troubleshoot your stove, fine tune it to the task you require, and fix your problems yourself without resorting to someone else’s customer service. The fact that you are learning a new skill, and a potentially lifesaving one at that, is another great motivator. In a disaster scenario the ability to boil water efficiently is essential. Fuel is likewise inexpensive or free. The aftermaths of disasters almost always will have broken lumber which provides a useful and readily available fuel, or they can burn previously overlooked fuel such as branches of smaller diameter (around the thickness or a finger or thumb works well in my little stoves) that may have been considered too small to be worthwhile issuing in a proper wood-stove. I have purposely tried to make all my rocket stoves out of locally available and free re-purposed materials, or very inexpensive materials which are readily available. I have found some ‘non-free’ materials really help the process, and create a superior product (like JB Weld) but I also want to be able to make them out of the most basic materials around if needed.

The Science of Improved Stoves
There are a number of principles that go into making a good rocket stove. From what I know, the most important is that they need to be hot. Very hot. The goal is create a clean, complete burn that burns the combustive gases and the particulate (smoke). For that you need temperatures that go beyond your simple three stone fires. Most of the other principles are a part of trying to create that heat required for a good burn. High temperatures equal full combustion. For that reason, improved stoves need an insulated combustion chamber, top keep the heat in. Pre-heating the combustion air makes a hotter fire. By having a shelf for the wood to sit on, air can move underneath freely, providing all the oxygen needed, and is heated by the fire before being burned. Thus cold air is not as likely to get into the main combustion chamber and reduce the temperature, keeping it hot.

A flange or shroud can be built to surround your cooking pot, forcing the hot air to move further along the side of your pot, transferring more heat to the pot and cooking your food faster.
Another principle is that the air volume in needs to equal the air volume out. Sounds simple when your inner chamber is a consistent 4” diameter, but when adding a shroud you have to make sure there is enough area/space in between the pot and flange for the equal volume of air to escape through the top. If not, you get a backdraft and smoke pouring out of the bottom of the stove.

Construction Basics
The basic design of any improved stove starts with an “L”-shaped combustion chamber. Combustion is meant to take place at the right angle corner of the “L”. The chimney/upper part of the “L” must be long enough to allow time for complete combustion of the gases. On the bottom of the “L” you typically run a wire shelf for the fuel (wood) to rest on. This allows air to enter horizontal portion of the “L” freely, beneath the fuel, and pre-heats the air before it gets to the actual combustion area.

Around this “L” is the outer sleeve. The sleeve should surround the vertical portion of the “L” completely, with a few inches gap in between to fill with insulation. You will need to cut a hole in the side of the sleeve for the horizontal “L” section, and in the top for the vertical “L” section. There are lots of ways and styles in which to do this. The main idea is that the sleeve holds the insulation against the “L”.

Three DIY Stoves
I made my first stove out of an empty white-gas/naptha can and some old drain pipe from a downspout on the house. I cut a 90 notch in the drainpipe, angled at 45 degrees to its length, with tin snips and folded it to make a simple 90 degree bend in the drainpipe. I then traced the entrance hole to fit the drainpipe on the narrow side of the naptha can and punched it out with a chisel and tin snips. I removed the top of the can with a can opener and tin snips, and traced and cut an exit hole for the vertical chimney portion of the drainpipe. I then sealed it with insulation (more on that later). I slid the top of the tin over the chimney drainpipe, and let it set and dry. I used a cut section of another drainpipe, drilled with a bunch of holes at one end, and slid into the horizontal section of the “L” as a rack to place the fuel on that also allows air to enter underneath and pass through the drilled holes directly into the coals of the fire. A wire rack for the pot to sit on top completed the stove, and allows for the smoke and flue gas to escape. So far this stove has performed fairly well. Not perfect, but an encouraging first attempt.

My second stove was a better built model, loosely based on a plan from the internet. Two #10 cans, one with top removed and one with top and bottom removed (with a can opener) become the body of the stove. I taped them together end to end along the interior of the can with duct tape. This allowed me to use JB Weld to join the cans together, which form the outer sleeve. When dry I removed the tape. The inner sleeve I made from purchased 4” stove pipe, though I later found that standard food tins are also 4” diameter, and could also be used. Having a 90 degree elbow stovepipe section greatly decreases the work involved, and makes the stove look much more streamlined inside, but I am confident I could work up a 90 degree elbow out of 4” food tins as well. Again, I cut holes for the 4” combustion “L” tube on the side of the lower can and on the removed lid of the upper can. Fill with insulation, replace the lid, add a fuel platform and pot rack, and viola. It has performed much better than the first, I think because there is more insulation, and perhaps because the height-to-diameter ratio of the combustion chamber is better. Either way it produces less smoke.

The third stove I tried came from a Webster called Practical Action (practicalaction.org) and is a build-in-place stove in the backyard made of simple red bricks. The principles are the same, creating an “L” shaped combustion chamber, tall chimney, insulate and create a fuel platform and pot rack. I like this type of stove particularly for use as a summer shack for outdoor cooking. It is easy to make, and can be made out of just about any sort of bricks, earth, or rock. Some in-place improved stoves get pretty fancy, similar to the old homesteading wood ovens, and have chimneys that vent right out of the house. The brick version is very similar to the survivalist “adobe stoves” that are dug into the side of clay hill side.

For any stove, efficiency can be greatly improved if you use a flange or shroud to surround your pot when you cook. It works by holding the hot gases close to the sides of your pot as they rise, rather than the gases just heating the bottom of your pot. I was able to make shrouds for a few pots, but they do have to be tailored to the size of your pot to maximize efficiency. I made mine by cutting a hole slightly larger than the diameter of the chimney into a round sheet of metal (mine came from a big popcorn tin). I put that over the chimney, and the pot rack on top of it. On goes the pot, and surrounding the pot I made a shroud out of the sides of the popcorn tin. It sits right on the bottom sheet, and I bend it to fit around whatever pot I use. I tend to leave about a ½-inch to 1 inch gap between the shroud and the pot. These work on the same principles that you see with many ‘windscreens’ for single burner back-country stoves like the MSR Whisperlite.

Insulation
I have tried three types of insulation in my first stove – wood ash, sand, and my favourite a concrete-perlite mix. Wood ash was messy, and though perhaps a very good insulator, it kept leaking out of the gaps in my stoves. You also have to be sure to use completely burn wood ash, or you may get an unintentional smoldering fire inside your stove. Sand was the second choice, and it worked well, but again leaked through any sloppy joints. I found that a mix of concrete and perlite (a soil additive from a gardening store) was the best all round for ease of mixing and performance in the stoves. Perlite is an inert volcanic mineral that has the consistency of small Styrofoam beads. It’s light and fluffy and very insulative. I mixed it with concrete to keep it in place, and it sets well, doesn’t leak out the gaps, and adds some rigidity to the stove so your whole pot weight isn’t sitting on the JB Welded joints. It’s another concession to modern materials, but if they are available then why not use them and get a longer lasting product.
I have seen informative instructions and videos on making firebrick, the gold standard in woodstoves for insulation properties, out of sawdust and clay which is then fired in a kiln. The resulting bricks are porous (the sawdust burns away in the kiln) and extremely insulative and lightweight. However, they are beyond my expertise and resources.
I also found that whatever insulation I use, I seem to get closer to complete combustion as the stove runs a while and heats up.

Caveats and Warnings
One issue that I was concerned with was the use of non-intended materials for cooking over. Galvanized stove pipe, for example, may release toxic fumes when heated. Even the liners from some food tins are probably not too nice if you burn them. I personally don’t feel this is a major concern if you cook outside and your pot has a lid on it. I also burn a good hot fire in the stove for a good while to hopefully cook out any fumes before I use it for food preparation. If I am frying, I do not use a shroud with my frying pan, and feel that most flue gas and fumes likely blows off in the wind. To be be completely technical remember that simply burning wood and other biomass releases carcinogenic chemicals that are likely not good for human consumption in quantity. I feel it is a measured risk. Each person must make their own choices for themselves.

Conclusion
Though a store-bought rocket stove is still on my wish list, I am happy to have an in-the-meantime solution to cooking without power, and one that can be replicated over and over, or adapted to the materials at hand, and given to friends and family. I encourage you to look online for plans – youtube has a several videos on making brick backyard stoves, for example – and get cooking. Though I have yet to rival the clean burning store models in my home-made designs, I find them very useful in the meantime, and as gifts in emergency “camping” kits.



Letter Re: American Redoubt Coverage

Jim,
I’m a long-time blog reader and occasional writer just dropping a note by you to say first of all that I love the blog. I read it everyday without fail. I support you by clicking through to your sponsors and purchasing items. One thing I would like to state for the record is my objection to the constant yammering on about the American Redoubt. [Some deleted, for brevity.] As one who has relocated from Florida to central Kentucky, I can tell you that there are more nice places to relocate to than just the Redoubt.

Once again, I love your mission, love the blog, and love the articles. Just stop mentioning the Redoubt so much. – Nickel Nick in Kentucky

JWR Replies: I now congregate nearly all of the articles that relate to the American Redoubt in a weekly column titled: “News From The American Redoubt”, on Tuesdays.  So if you want to avoid most of the Redoubt mentions, then simply skip reading that weekly column.



Economics and Investing:

Der Spiegel reports: Investors Prepare for Euro Collapse

Welcome to the land of the poor and rich – Trading the middle class for economic extremes.

Deep Fried Black Swan Lands as China Admits it Has a Food Inflation Problem, Releases Corn, Rice From Reserves. (Thanks to H.L. for the link.)

Three Warning Signs Showing Why You Should Remain Leery of this Market
 
Why Alternative Energy Will Never Become Widespread in Our Lifetime

Items from The Economatrix:

Presenting The Ultimate “Muppet” Indicator

The US Treasury Secretary’s $2.4 Trillion Secret

Are You Better Off Than You Were Four Years Ago?

Egan Jones Downgrades Goldman Sachs From A- to BBB+



Odds ‘n Sods:

Camping Survival has announced an unprecedented Two Day Free Shipping Deal. This is for every order of $149 or more from their web site received on August 15th and August 16th. Free shipping is available only if you use coupon code “freeshipping” during checkout.

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Reader Diana V. suggested this: 100-year-old way to filter rainwater

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Gary S. mentioned: Cloak of Invisibility?

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F.G. sent this: Conquest vehicles reveals the Evade, its new, gigantic unarmored SUV. JWR’s Comments: They should have named this vehicle the Poser. Driving an unarmored vehicle that looks armored is something akin to openly carrying an unloaded gun. What idiocy. Owners will just be looking for a fight that they know they can’t win. This article reminded me of one of my late wife’s favorite treble entendre sayings: “If looks could kill, there’d be lifeless bodies littering the streets.”

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H.L. sent this: As drought looms in India, fear for its cattle

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Sandman mentioned an article on government databases that are tracking license plates



Jim’s Quote of the Day:

“Emergency preparedness is a good thing for governments to focus on. But whether talking about the Elliot Lake mall collapse in Ontario or the ongoing efforts to turn Calgary’s communications back on, there’s ample evidence that governments are simply incapable of adequately tackling the complexities of disasters confined to even a single building. If something big ever happens — and sooner or later, something always does — we should all expect to be on our own for days, or longer. The systems we’ve built to support ourselves are just too complicated to repair any faster than that.” – Matt Gurney, The National Post, July 12, 2012





Essential Medical Skills to Acquire: Part 2, Suturing, by Cynthia J. Koelker, MD

In Part 1 of Suturing I discussed several aspects of wound closure, including goals of treatment, common lacerations, alternate wound closure techniques, types of suture to purchase, wound cleansing, sterile field, needle size, proper instruments, correct suture placement, and aftercare.

In Part 2 of Suturing I will address common mistakes to avoid.

Wound closure is not rocket science
, and any adult of average intelligence can learn the basic techniques.  Anyone who has sutured has learned from their own mistakes and those of others.  The following advice will help you skip a few errors and should make you look like a professional.

Common Suturing Mistakes to Avoid


Diagonal sutures yield misalignment
, often with “dog ears” or leftover skin remaining on one side, which will cause a puckered appearance or open area at one end.  Make sure to align the edges well and place your sutures exactly perpendicular to the wound edge, aligning each stitch as you go.

Over-tightening yields inversion of sutures
, that is, the edges dip into the wound, which prevents proper healing.  The sutured wound may look great, but what you really have is intact skin butting against intact skin, which of course isn’t going to grow together.  You need to have raw edge against raw edge, preferably with these edges everted a little (tented outward a bit).  As the wound heals they will flatten out.  Eversion is best accomplished by making sure you suture to the full depth of the wound with stitches as far from the edge of the wound as the wound is deep.  If the wound is a quarter-inch deep, sutures should be placed a quarter-inch away from the wound on each side, yielding a distance twice that (or one half inch) from side to side.

Likewise, suturing uneven thicknesses together often yields overlapping skin edges
, which also will not heal together.  In this case the raw skin edge overlaps onto intact skin.  Take care to check each suture as you go for tension adequate to close the wound but not enough to overlap tissue edges.

Under-tightening yields loose sutures with a gaping suture line
.  Be sure to use the surgeon’s knot (a double loop) on the first throw (half knot) of each suture.  This prevents knot slippage, which is especially helpful with nylon suture.  Raw tissue must touch raw tissue for the body to bridge the gap quickly.  It’s not that a gaping wound won’t heal, it will just take longer and cause a wider scar.  Everting the edges a bit, a millimeter or two, helps prevent this problem.  

Superficial sutures result in poor healing
.  Your stitches may look great on the outside, but if the deep layers do not touch each other, they cannot grow together.  Make sure to close the laceration to the full depth of the wound.

Using large needles and/or suture material on fine skin yields needle-hole scars
.  On tender or facial skin, better to use multiple fine sutures (5-0 or 6-0) placed closely together than try to bridge the wound using fewer, larger sutures.

Using too fine of suture on areas of greater thickness or tension may yield stitches that pull through
.  Only use 5-0 on fine skin such as the face, fingers, or children’s skin.  Use 4-0 for most standard lacerations where the wound is just through the skin and/or where tension across the wound is minimal.  Use 3-0 for deeper lacerations into the subcutaneous tissue and/or where tension across the wound is greater, especially over large joints.

Leaving sutures in too long also results in needle/suture hole scars
.  On fine skin which is not under tension 3—5 days is sufficient.  Average lacerations not under tension require 5—7 days before removal.  Deeper wounds or skin under tension require 7—10 days, though up to 14 days is recommended if healing is in doubt.  In patients whose sutures are left in longer they typically become embedded in the healing skin, which makes them difficult to find and remove.  If you suture someone up, examine your work daily to get an idea of the rate of healing. This only takes a minute or two, and also helps diagnose infection early.  If in doubt whether it’s too soon to remove stitches, take out only one or two in a non-critical area and see if the suture line holds.  Sometimes doctors take out alternating stitches one day, then the rest a few days later if wound strength is in question.

Leaving infected sutures in results in needle/suture hole scars and delayed healing
.  Once a wound has pus coming out or begins to look red and swollen, all sutures should be removed.  The wound will heal better once the pus is rinsed out, though may well require oral antibiotics (cephalexin, trimethoprim-sulfamethoxazole, or amoxicillin-clavulanate are all good choices).  If the infection is caught very early, removing the stitches and applying a topical antibiotic such as bacitracin, Bactroban, or possibly Triple Antibiotic Ointment may be sufficient.  (Doctors seldom recommend the latter due to increased likelihood of allergic reaction, but if it’s all you have I’d use it.)  I have not used honey for this purpose, but it may work as well.

Sutures placed too close to the wound edge may pull through
.  Placing your sutures about an eighth to a fourth inch from the wound edge is about right – the deeper the stitch is, the wider it should be.  Better a bit too wide than too narrow.

Just as women can learn to make a dress by reading a book, you can learn to suture on your own.
  However, most people feel more comfortable if they’ve had professional supervision, at least to begin.  To this end I offer workshops several times per year where students can perfect their skills and receive professional instruction.  (See my web site for upcoming classes.)

In the next article I will discuss Splinting and Casting

About the Author: Cynthia J. Koelker, MD is SurvivalBlog’s Medical Editor, the author of the book Armageddon Medicine, and the editor of ArmageddonMedicine.net   



Letter Re: Army Scout Field Manual Available Online

JWR,
I thought I’d take a minute and recommend an Army Field Manual (FM) that I don’t see referenced too often here. It’s FM 7-92 (“The infantry reconnaissance platoon and squad; airborne, air assault, light infantry”) with Chapter 9 for MOUT/urban operations. This version is a little hard to find, so here’s the link.  Just don’t ask why I had to go to Marines.mil to find it.

This version dates back to the late 1980s and early 1990s, so the emphasis less on mechanized reconnaissance, technology, and general eye candy – unlike a majority of the scout FMs in current publication. It covers water movement, tracking, dismounted infiltration, etc. It’s also interesting to see the parallels between these older scout FMs and the newer six-man sniper teams. Having been in the scout platoon of the 187th Infantry Brigade, I’m sure that I’m a little biased, But from my perspective this is one of the most valuable FMs out there for WTSHTF.  Of course it should be read after the general infantry FMs, but the focus here is on small group operations, and helps to develop the skills needed to extend your area of influence well beyond your own personal camp-de-resistance.

Enjoy, – Robert in North Carolina



Letter Re: A Flooded Basement and Rusting Canned Foods

Hello Mr. Rawles,
Regarding the man who found his canned food rims rusting in his basement. I can recommend OSPHO, which is a liquid which will upon application changes the rust to a more stable compound. I was in the Merchant Marine and we used it on the ships and it works very well. You can get OSPHO through Amazon.com or at a ACE hardware store. It is basically phosphoric acid [suspended in a coating.]
 
He may also want to invest in a tabletop buffer or wire wheel to quickly remove surface rust before applying the OSPHO which improves the effectiveness.
Thanks so much for your site, I read it each morning. – Robb M.