when I saw front page News in Mumbai Mirror about " Ward boys doing Doctors work in a Hospital in Mumbai", I was more amused than surprised.Because thats an Age Old Practice in India. When I was medical Student in K.E.M. Hospital Mumbai, C.L.W. Suturing was done by wardboys in Casualty. to my knowledge practice is still continuing in all the hospitals. Most probably it started off during World Wars when such wounds were sutured in battlefields by Medical Staff.

C.L.W. is "Contused Lacerated Wound". One gets it when there is any accident,fall while playing,a brawl or any form of injury. One on Scalp are most common, they are difficult to detect as hairs hide them and easiest to suture. You have seen Stallone " Self Suturing" a CLW in Rambo I-First Blood. Next to 'taking out Bullet with Pocket/Kitchen knife', its most common method to show Masochism in movies.

In Casualty, once its established that there is no other serious underlying injury like Fracture or Bleeding, CLW suturing is done and person is sent home. CLW suturing is done to stop bleeding and wound heals in week's time with thin scar. If suturing is not done than wound may bleed and healing takes longer and may leave ugly scar. Suturing is very easy and is more like Sewing done at home. only difference is that one uses Sterilized,Surgical thread with Surgical (Trocar Pointed) straight or Curved needle. Suturing with Curved Needle requires training and skill. With straight needle- most common - it's very easy. Thats why No one wants to do it, and it ends up with Lowermost person who cant say NO. Thats wardboys in Casualty.

In surgery its most basic thing and every one starts off with it. If in casualty Intern is posted or better, if students doing Surgical posting are there then they are given this job as favour. Wardboys are asked to 'Assist' them( Nursing staff wont bother to assist such a simple operation!) with warning for CLW on Scalp that " Take Care and dont push the Bloody needle in the brain". with merriment all around as soon as Students back is turned. Procedure is done with all the surgical care and observing most of the surgical principles. hands are washed, Gloves are put on, Wound is properly cleaned, towels are used to isolate the wound and sterile Technique is used while suturing. In short everything is done as if this is a proper, major surgical procedure. only problem is that Suturing requires no great Skill, hence for busy,overworked Casualty officer, its a burden and irritant which he wants to pass off to someone.

As the procedure is simple and done by person not using skill, result is 'ugly scar". In the case of Head wound, hairs can hide the ugly scar but if its on face or other prominent visible place than scar looks hideous and may require plastic surgery in future. So any wound on face, arms, Legs are referred to Plastic Surgeon. In Public Hospital this means wasting 3-4 hrs as Plastic Surgeons are overworked and they take pretty long time to suture the scar. But they will hide it. In private Set up this is costly affair and may set you back by 10-15K + service charge! Only you will know where the scar ( proof) of abusive,violent husband is and can show him to end all future arguments and fights!