hey thanks for joining us we have
Michael who tore up the back of its lay
on the car if you did how'd you do that
I slammed the door on it don't ask me
how I did that on your own leg yeah oh
man I could see doing it on someone
else's leg but on your own yeah but with
I hide all right well we gonna start
repairing this so let me have you lay
facing down so Mike the reason I I made
a funny face when we were talking about
how long it's been yes if you catechins
been 15 hours right well there there is
kind of a a wisdom that's not
necessarily wise in medicine that you
don't repair wounds if they've been open
for you no longer than six hours or so
that you leave them open and wait a
while before because the thought was
there's an increased risk of infection
well with good irrigation of wounds we
found that you can do it a day later and
it's okay there's good evidence to that
point so if people are watching this
video who have heard oh you can't close
something if it's been open for six
hours actually the literature shows that
you can there's good emergency medicine
literature that's been done that shows
that the infection rate is not higher
with the wound you leave or the one you
close compared to one that you we've
opened so we'll go ahead and close this
because you actually have fat sticking
out of your wound and you just can't
walk around like that well it depends I
guess it depends on what what social
group use tend to identify with but most
most of us can't just walk around with
that hanging out of our legs okay this
one's yours
anyone can cook cleanser around this so
zooming will be done by stepping forward
stepping backward that's okay so this is
just the is that stinging at all no this
is the antiseptic and we will need a
fenestrated rate for this okay so this
is going to get on the floor we don't
have a bucket but here ya so everybody
has their splash shield on here we go
we're going to irrigate out in the
eighth okay you feel on that and every
go and then you know good that caught it
on the floor pretty well all right it
does a little I'm going to give you some
injections of some anesthetic and I have
a principle of injecting in the wound is
that burned it's a hurtin maybe a little
bit the reason I do that is because
you're avoiding some of the pain
receptors by injecting in the inside of
the wound like that whereas if you go
through in text skin you're hitting all
of the senior centers so it actually
hurts less now we got it on this up
that's what we're doing now all right
are you feeling it at all Mike I'll go
down there you go so we're giving me a
shot oh we're also ordering a tetanus
shot for you because I looked in your
tetanus shots aren't up to date okay but
your insurance will pay for it now yeah
all right you half we get some sterile
gloves on and really explore that that's
another essential part of the process is
the exploration exploration my hurt now
oh all right so yeah you can see some
potentially devitalized tissue there
actually looks pretty good
so this is what we irrigate it and I'm
just making sure I don't find something
you can actually feel like a rock
although you didn't do this on this road
this was just the was a bumper know the
car door the car doors so unlikely that
anything broke off the door and got
stuck in here but there could have been
bits of clothing maybe if you're wearing
clothes do you wear clothes Mike okay
well you know I just have to ask on
everybody alright so we're good so with
a clean wound even though it's been 15
hours we irrigate it well we're going to
close we are not going to use
antibiotics because the incidence of
infection with antibiotics
prophylactically is not any less than
when you do when you don't see you so
first I'm going to do is buy sec to the
loon right right in the middle naturally
by second cut anything but
we need to get the feel right there all
right pull that together
now a lot of the videos people watch
they'll see an assistant cut the suture
for the doctor that we don't quite have
some that fancy yet do you bisect it
yeah yeah put one suture right in the
middle to make to roughly equal halves
and then go in and do it again with one
of those halves so we'll put in three
sutures I often put in an odd number of
sutures because I do it that way that's
just how do you yeah that's how I do it
it's my technique not everybody's
technique but my technique a lot of
times we get people to write comments
and our videos that you know if they see
other techniques from other doctors
they'll write about how they're
different and a little discussions about
the pros and cons of different ways of
doing things
so let the keywords to look you up
Auburn Auburn medical group and that
will get our channel on YouTube or if
you go i'll burn medical group com then
you can click on the little YouTube icon
at the bottom of the page or for some
people there's patreon.com / auburn
medical europe which that's that's some
extra stuff that's like behind the
scenes and like a video we're putting up
next week of course by the time somebody
sees this would already be up there's a
I did an injection on somebody's knee
and I actually went in the wrong spot
pulled back and then put it in the
correct spot but the whole part about
putting the wrong spot I cut that part
out for the one that goes out to the
public that's just for the people that
are paying a little bit to watch the
extra stuff yeah so we'll put a little
bandage on this because it will just use
a little bit you can see some boozing
from that suture right there and we will
keep a close eye on this Michael need
you or Lorraine to be looking at this to
look for redness spreading around it or
if you get a fever or puff comes out of
it will have to put you on some
antibiotics and we'll give you a tetanus
shot before you leave today thank you
for your patience how you feeling I'm
feeling great it's so good reciate to
find work highly recommend Auburn
medically am I supposed to say that how
much am I supposed to pay you for going
and cut in your leg to do it but we'll
start with let's talk about we should do
that with this hey thanks for joining us
Mike's a great guy and I'm sorry this
happened to him but I was really glad to
get him on the video because he's cool
your whole family's cool Glenn Glenn
yeah so thanks for joining hey if you do
want to see this behind-the-scenes
videos that we talked about you can
become a member of our patrons or a
patreon is going to cook for that and
until next time type myself dr. mark on
telling you to stay good out thanks so
much okay you leave