Sewing but not for the squeamish pt.2

If ADHD is such a terrible thing, why do the world’s newspapers conspire for a piece of mine? I need no further proof than Surgical stitching: a beginner’s guide from the Guardian:

Perri Lewis is an accomplished embroiderer – but how would she cope with sewing wounds?

Having patched up jeans, darned socks and mastered all kinds of embroidery, I assumed I could have a good stab at stitching up a body. But when I was given a small, neat wound on a fake arm to practise on (made of red sponge and a sort of leatherette), not fainting is my first challenge…Luckily, crafting served me well and instinctively I stick the needle into the fake arm at 90 degrees, close to the edge, but just far enough away so it won’t rip – just as I would with fabric.

My earlier entry was about the distribution of tension and cut patterns surgeons use to offset and minimize “seam failure” (they obviously have a name for it). I found it interesting with many analogies to working with leather. With this medium, you learn to push the boundaries of cut lines, performance and fit. I thought it would be good to talk about because I think people are rigidly wedded to fabric grain; ours is not an x-y coordinate world. It is advantageous for varying garment sections to be off grain; I explained some of this in laying out a hide.

Thankfully, Mother Nature conspires to undermine grain line militants -I’m smiling when I say that- consider armhole shaping. If that were on grain, sleeves and armholes would be even more atrocious. Perhaps you scoff “armholes are supposed to be off grain” which is abjectly true but who says center fronts and backs must be on grain? Who? Other than whoever taught you? They didn’t used to be. And some of us are downright anarchists because we dare suggest this roundly accepted concept may not necessarily be true. Perfectly vertical CF and CB are an artifact of manufacturing, it made for easier and more efficient yields. Pinky swear.

I’m having a bit of fun with you, do read the earlier entry. Some of these cut lines are adaptable to bias and other off grain situations if you’re into experimenting a bit. Case in point on the first squeamish sewing entry, Jeanette remarked:

As a physician I use my sewing skills often, however, for the first example above I would actually undermine the wound to allow me to draw the edges together, this is easy to do on the scalp as there are several very strong layers of fascia and muscle to pull the tissues where one would like them to go, However this technique does not translate to fabric. The Z-plasty however does and is rather cool.

z_plastyAfter that I had to look up Z-plasty. American Family Physician describes it thus:

Z-plasty is a plastic surgery technique that is used to improve the functional and cosmetic appearance of scars. With this technique, it is possible to redirect a scar into better alignment with a natural skin fold or the lines of least skin tension. Contracted scars may be lengthened with this technique. Z-plasty involves the creation of two triangular flaps of equal dimension that are then transposed.

Z-plasties are cool. The one at right shows most of the wound closed unobtrusively using facial features. You can thank me later that I didn’t write an entire post about these.  Image courtesy: Patrick Knipper

And then I had to look up suturing videos -I did tell you this was about newspapers conspiring to feed my ADHD- and found one courtesy of the U.S. Army. I found the first part (how to use the tools) to be unintentionally hilarious. It reminded me of someone we all know. Did I ever mention I was an Army Brat? The apple does not fall far from the tree. I love to watch doctors tie knots in suturing but they do it so fast I can’t follow it (with the hopes of using it). This US Army training video shows the technique about midway through the piece. You can bet I’m going to try that.

Or I may just stick with duct tape. Hey, if it works to hem pants, it works on cuts. And you think I’m kidding. I actually did do this once -I’ll omit the long story- but the doctor was really impressed and refused to remove the tape to suture it. And it did heal very prettily. I used very narrow strips, maybe 1/4″ to 3/8″ wide and spaced them as stitches would have been.

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  1. Elaine says:

    :) lolol. Wonderful. I’ve done the tape thing too (on skin.) It works well unless the patient is sensitive to the adhesive…then you get blisters and their scarring too…

    A question I’ve been wondering: Does the straight line center front thing in women’s bodice drafting have anything to do with not wanting a center front seam or opening in the garment?

  2. trudy says:

    Sorry in advance if this is TMI…as it happens, I have 2 large (each line about 5″ long) z-plasty scars on my right arm…one in the crook of my elbow, one in my armpit, these were done as repairs to my large scald (happened when I was a baby) which reaches from the neck to the crook of my elbow. they were done so I’d have freer (sp???) movement. I distictly remember the (British Army, I too was an army brat) surgeon tell my before the elbow surgery in about 1980 that they were going to cut the skin diagonally because skin is just like fabric, and stretches on the diagonal. Bias cut skin, there’s a bizarre concept! I also remember my Dad, a nurse in the British Army, being able to suture really really fast…with one hand. He had to stitch my sister’s chin up when she was about 3 or 4 and fell off a climbing frame…held her down with one hand, stitched her up with the other, didn’t leave a scar! My Dad rocked…

  3. Kathleen says:

    Trudy, that’s hilarious. About your dad holding down your sister I mean. Not the part about your innards spewing all over creation. heh.

    Does the straight line center front thing in women’s bodice drafting have anything to do with not wanting a center front seam or opening in the garment?

    You do what’s needed depending on design requirements. Point is, the practice of rotating the dart created in making the CF straight, and putting it into the neckline, has been long abandoned. This is what I like about Burda home sewing patterns. Many of their jackets have neckline darts.

  4. Theresa in Tucson says:

    Kathleen, your duct tape technique is something my mother always referred to as a “butterfly”. She was an RN of the old school, trained in the Nurse Cadet Corps. With eight rambunctious hellions she saved us many a trip to the doctor for stitches by her thrifty use of “butterflies”. It is a viable low tech technique. Terrific subject. Having watched an ER doctor or two stitch up wounds it is definitely a skill and some of them do refer to it as embroidery.

  5. Million says:

    I’ve recently redone most of my pattern blocks that I use for myself with CB perfectly straight, because I was under the impression that it was preferable, but I have to admit that most of my best fitting patterns prior to that had the lower back taken-in significantly. The human back is definitely not straight, and this is coming from someone with excellent posture (I’ve been doing yoga since ’96).

    I love how you investigate subjects like this one, and I had never considered the stitching technique of surgeons before. Thanks for the post!

  6. Kathleen Gaffey says:

    Now, I’ve taken out my own stitches, but to put them in?? Hmmm, a whole new activity, although I think I’ll leave it to the guys/gals in the white coats. However, I do use duct tape and super glue for all sorts of finger cuts. Thanks for another informative topic!

  7. Dan says:

    Hello there, Kathleen!

    I remember an older post where you talk more about your ADHD, but I can’t find it anymore. How did you find out about your ADHD? At what age? What was the course of treatment, from beginning until the present?

    Sorry for feeding into your ADHD, but I thank you in advance for the information! ;)

  8. Kathleen says:

    I don’t think I’ve written about ADHD, maybe you mean autism? I was Dx-ed with ADHD in 1996, I took Ritalin for awhile (which I thought was great) but treatment now amounts to a combination of coping strategies and resignation. That sounds cavalier, I know ADHD is a big deal to a lot of people but for me, it’s like parsley on my plate considering the broader spectrum of cognitive and learning disabilities I have. It bothers me a little that people minimize their severity because it appears seamless to them, that I’ve “overcome” them. By analogy, if you’re blind, learning to become more functional doesn’t mean you’re not blind anymore. Adapting represents a constant life-long battle with never ending challenges. I’m not bitter about it though and regret if it appears I am.

  9. Dan says:

    Yes, you’re right, it was autism!

    It’s absolutely incredible to think that you have these kinds of disabilities, and yet you read more books than I read blogs, and you’re incredibly knowledgeable as well as a hard worker.

    If you ever feel like writing about ADHD, it would be interesting to read, for me!

    Thank you for your answer! :)

  10. Jonquil says:

    “Adapting represents a constant life-long battle with never ending challenges. ” Yes, exactly. This is my life, it’s the only one I’ve got, and I deal. (I have disabling migraine.) When I had stitches on the back of my hand in 1977, part of the area was held down by a tape butterfly (obviously commercially made) and part by stitches. It healed quite clumsily; it probably would have been better to have gone to a plastic surgeon for such a visible part, but I’ve always rather liked the big dramatic scar. I want to claim it’s a saber scar but actually I fell crossing a bridge.

    I have a patterning question. I’m looking for a princess blouse pattern right now, and nearly all the ones I can find curve the side panel into the armhole rather than carrying it up over the shoulder. My sole patternmaking book (Adele Margolis) shows the side panel carried up to the shoulder and I think it looks smoother and more flowing. Do you have an opinion on which you prefer as a designer, and which as a patternmaker?

  11. Jonquil says:

    (Note that I was sixteen when I fell and hurt my hand, and I think at that time it was unusual to go to a plastic surgeon to have injuries stitched up, at least in my small town.)

  12. Matt P says:

    I’d hate to further feed your ADD, but there’s a wonderful little book on wound closure techniques that you might find interesting. It is “Wounds and Lacerations” by Alexander T. Trott. Wonderful illustrations and more information that anyone who isn’t a reconstructive plastic surgeon really needs to know.

  13. Seth Meyerink-Griffin says:

    Personally, I think that the superglue solution works a little better and faster than duct tape. I have a friend that works in a factory that keeps it on-hand at all times. Anything short of amputation he just glues shut, covers with an adhesive bandage (to keep it clean) and goes back to work.

  14. Dr T Qamar says:

    I do surgery on eyes (for Lasik vision correction, cataracts etc.) and – with a few obvious exceptions – I’d say that sewing is sewing. The quality of your own vision, steadiness of hand, and patience will be just as important in any type of needlework.

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