Lacerations

D. E. Larsen, DVM

The big Holstein cow groaned a little as we pulled the massive calf out through the large incision in her right flank. Dr. Reese and I had been working for some time doing this C-section. To say this was an oversized fetus was an understatement. This was the largest calf I had seen delivered by any means.

Dr. Reese was one of the large animal interns at Colorado State University vet school, and I was in my senior year of study. Now, with the calf safely in the hands of several junior students, we could concentrate on closing the incisions. Usually, closing the uterus and the flank incision are the most time-consuming parts of a C-section on a large cow. In this procedure, however, getting the calf out was a difficult task, and both Dr. Reese and I were a bit tuckered out.

The closure went well until we got to the skin. The cow’s skin is thick, and even the sharpest suture needles are difficult to push through. After school, I would witness some veterinarians use a leather punch to make holes to lace the suture through. 

It was probably when Dr. Reese was placing the third skin suture that he lacerated the middle finger of his left hand with the needle. The laceration was less than an inch long, but it was deep and right across the first knuckle.

“I can suture that for you if you want,” I said.

Dr. Reese looked at the laceration and swore under his breath.

“No, I better go to a real doctor,” he said.

We finished the surgery, and Dr. Reese left to go to the Student Health Center to get the laceration sutured.

Later, he stopped me in the hall and showed me his finger.

“I should have had you suture this,” Dr. Reese said. “The guy didn’t even line up the creases in my knuckle.”

***

Some months later, Sandy and I were busy organizing the kitchen in our new rented house in Enumclaw, Washington. Brenda, a third-grader, was old enough to help a bit.

Halfway through getting the kitchen boxes unloaded, Brenda managed to run her forehead into the corner of an open cabinet door. She had a nice one-inch laceration above her forehead, just inside the hairline.

“What do you want to do?” I asked her. “Do you want to go to the doctor, or do you want me to suture that wound?”

“I want to go to the doctor,” Brenda said with some finality in her voice.

Off to the emergency room, we went. I don’t remember the doctor’s name, but he seemed efficient. He had Brenda lying on a table in the emergency room as he got ready to inject some lidocaine into the wound. He held a wet towel above her head.

“I will just drip some water on this cut,” the doctor said as he squeezed the towel, dripping some saline into the wound and on her forehead. At the same time, he stuck the needle into the wound and injected the lidocaine.

That stuff hurts, and Brenda let him know that it hurt.

Brenda was unhappy when we were leaving.

“I should have let you do the stitches,” Brenda said. “That doctor lied to me.”

***

It was another few weeks when I had a call to castrate a group of young bulls. These were all three hundred pounders, large enough to be a job but small enough to be relatively each to handle.

“Have these guys been on a clover pasture?” I asked the owner.

“No, what difference does that make?” she asked.

“Clover has a lot of phytoestrogens, and those can interfere with blood clotting,” I said as I moved behind the first bull in the chute.

I grabbed the scrotum with my left hand and squeezed the testicles down to the bottom of the scrotum. I made a couple of quick slices on each side of the scrotum with my scalpel. The second slice also included a nice clean, two-inch slice in the heel of my thumb.

“Ouch!” I said as I looked at the laceration.

I stopped and washed the wound on my hand with Betadine and injected it with a bit of lidocaine. Then I put on a surgical glove and returned to the job.

When I got back to the clinic, I didn’t have time to go to the doctor, and after Brenda’s experience, I decided I could suture it myself.

“Are you sure you can do this?” Ann said.

“I think so,” I said. “I will use a continuous suture pattern so I won’t have too many ties to make.”

I injected a little more lidocaine into the wound, which was the hardest part. I cleaned the wound well with Betadine scrub and laid my hand on a sterile towel as I picked up the suture needle with the needle holders.

In school, when Doctor Creed watched as each of us, one at a time, did our surgical ties on a practice board in front of him, I hurried through my one-handed tie because I had failed to master the technique.

“I’m not sure that was quite right,” Doctor Creed said. “But it was fast enough that I will let it pass.”

Now I wish I had worked harder on learning the one-handed tie. I struggled with the first knot but finally made the knot. It was the same on the other end of the closure, but I did it.

“That doesn’t look too bad,” I said as I held my hand up for Ann to see.

***

Although it is not entirely obvious, I still have the scar because it has become one of many on my left hand and arm.

When I lacerated my left forearm with a scalpel when a larger bull calf kicked in the chute as I was castrating him, I went to Corvallis to have it sutured.

I waited for some time, nearly a half-hour, in the immediate care unit before they called me back.

“How did this happen?” the nurse asked.

“I had a soon-to-be steer kick when he didn’t like my services,” I said.

“Oh, on-the-job injuries have to go to Occupational Medicine,” she said.

“And where is Occupational Medicine?” I asked.

“It is over at our annex,” she said as she cleared the tray she had prepared for me.

The annex was a couple of hundred yards walk from immediate care. A long walk but too close to drive.

There was a gal at the reception window when I entered.

“What can we do for you today?” she asked.

I held out my forearm for her to see. I had not reapplied the wrap after the nurse had removed it at immediate care.

“Oh my!” she said. “That looks like it hurt.”

“Yes, it hurt,” I said. “What are my chances of getting it taken care of today?”

“The problem is we won’t have a doctor here until two o’clock,” she said.

I looked a the clock. It was eleven forty-five.

“I will do it myself,” I said as I picked up my papers.

She didn’t say anything but had a surprised expression as I turned around and left.

Back at the clinic, I scrubbed the would and injected some lidocaine.

Progress made things a little easier. I closed this wound with staples in a couple of minutes. 

I probably saved the insurance company a thousand dollars.

Photo be Karolina Grabowska on Pexels.