redness around it on the third day and the remainder on the fifth day. b. Body and scalp: 7 days. c. Soles, palms, back, or over joints: 10 days, unless excess tissue reaction is apparent around the suture, in which case they should come out sooner. d. Any suture with pus or infection around it should be removed immediately, since the suture's presence will make the infection worse. e. When wire is used, it may be left in safely for 10 to 14 days. ORTHOPEDIC INJURIES Many kinds of accidents cause injuries to bones, joints, or muscles. In giving first aid or emergency treatment to an injured person, you must always look for signs of fractures (broken bones), dislocations, sprains, strains, and contusions. An essential part of the emergency treatment for fractures consists of immobilizing the injured part with splints so that the sharp ends of broken bones will not move around and cause further damage to nerves, blood vessels, or vital organs. Splints are also used to immobilize severely injured joints or muscles and to prevent the enlargement of extensive wounds. You must have a general understanding of the use of splints before going on to learn the detailed first aid treatment for injuries to bones, joints, and muscles. SPLINTS LEARNING OBJECTIVE: Recognize the different types of splints that are available, and determine how and when they should be used. In an emergency, almost any firm object or material will serve as a splint. Thus, umbrellas, canes, rifles, tent pegs, sticks, oars, wire mesh, boards, corrugated cardboard, and folded newspapers can be used as splints. A fractured leg may sometimes be splinted by fastening it securely to the uninjured leg. Whenever available, use manufactured splints such as pneumatic splints or traction splints. Requirements Splints, whether manufactured or improvised, must fulfill certain requirements. They should be lightweight, strong, fairly rigid, and long enough to reach past the joints above and below the fracture. They should be wide enough so that the bandages used to hold them in place will not pinch the injured part. Splints must be well padded on the sides touching the body; if they are not properly padded, they will not fit well and will not adequately immobilize the injured part. If you have to improvise the padding for a splint, you may use clothing, bandages, cotton, blankets, or any other soft material. If the victim is wearing heavy clothes, you may be able to apply the splint on the outside, allowing the clothing to serve as at least part of the required padding. Fasten splints in place with 4-45 Wound Suture Material/Size Children under 3 years 6-0 All other faces 5-0 Body 4-0 Feet, elbows, knees #34 or #36 wire, or 4-0 Child’s scalp 4-0 Adult’s scalp 3-0 Lip 6-0 or 5-0 Table 4-4.—Suture Guide Figure 4-33.—Suturing.