There's more than one way to skin a cat.

I've cut my finger at Burning Man while taking down our shade structure - 8 days on the playa without a bath. My skin was coated in playa powder, sun block, and skin moisturizer. The key was to use a band-aid big enough to wrap around my finger and stick to itself. shrug - cleaning the area around the skin would have been preferable, but I wouldn't use alcohol for that. Soap and water works fine, if you've got it.

If you have a wound on an area the band aid won't reach around, and you're out of ways to clean the skin, either run a piece of tape around the limb (I've got yards of surgical tape in my kit), or put a gauze pad on the wound and tie it with fabric.

Oh, and crazy glue works, too. Just glue the cut shut.

I'm in scafool's camp - for mass casualties its triage, stop bleeding, bandage, move on to next case. When you have time (and in a really bad situation you have 24 hours or more before patients can reach medical assistance), go back, and inspect the wound, clean, probably with ordinary water and the big bottle of betadine in the mass casualty bag. You may need to irrigate a wound before you close and bandage it, but as long as you aren't introducing new sources of infection most folks will be fine if you bandage them and have the next level of medical assistance deal with possible infection.

fwiw I keep 2 L of water in my car with my casualty bag (which has irrigation syringes), and an 8 oz bottle of betadine.

An endorsment for scafool: anything that kills microbes kills the healthy tissue at the margins of the wound, slowing healing and speading infection: saline, soap and water work fine. If I cannot get the wound and edges clean, then I do not want to close the wound, cuz a closed wound with an infection in it is an abscess, and lots harder to treat. If the wound and margins are clean, and I want the steri-strips to stay on for awhile, I coat the intact skin that will receive the adhesive with tincture of benzoin, and then apply another coat of benoin on top of the steristrips. Keep it out of the wound. Hurts. Izzy: avoid nosebleeds by coating the inside of the nose with petroleum jelly-antibiotic ointment, chapstick, carmex and vicks all work well, tho the latter two choices are sort of exciting.

A bit off topic here, but everyone that's carrying around betadine realizes that it needs to DRY before it's actually sterilized anything, right?

I also agree with scafool. I have been certified in First Aid, my training can be summed up as this, "I am not a doctor, but I can help you get help." immobilization and not causing further harm are the two big ideas that I took away from it. Just because I have a needle and thread, or superglue, does not mean I should attempt to sew/glue someone else together, and i would be LIABLE if i did. Good samaritian laws protect people giving first aid but they do not cover "I saw this on ER last night...." or "I have read about this in an old army manual so I must be a medic" type stuff. First aid is about keeping a person alive, intact, and not getting further hurt. Its not about being a superman. I am qualified for rescue breathing, not intubating. I can splint a broken bone, not set and cast it. (only if there is a need. If the paramedics are in route I wait and monitor) My number one priority is to get help.

I agree with the OP pretty well, I figured out with my last busted knuckle at work that 4 iodine wipes are just about useless. (I was changing the oil on a car so i had oil and grease on my hands it sure did make opening the foil package fun too!) simple soap and water is a much better choice. I mean simple soap, we also have the soap that has grit in it which is a really bad idea to clean a wound with.

for minor scrapes and cuts usually I make sure the cut site gets flushed by blood, then bandage with a little triple A. No washing or alcohol or iodine. the bandaid sticks, I dont kill extra cells, the triple A keeps the cut clean and non-sticking. I understand many will not approve, but think back to when you were a kid.

Wrapping the bandage completely around the digit, limb, or trunk certainly helps keep any pad in place. It works really well if the person isn't all that greasy or active. But I've a;so seen bandages simply slide off if they aren't attached to skin by adhesive or substantial friction. Fingers are possibly the worse for this. they tend to be grimier, greasier and more mobile than other parts.

Of course we are talking about seriously grimy and greasy folks here. Your average well-cleaned 8 to 5 office worker is a suitable target for bandaging without a whole lot of preparation.

On the other end of the scale is what you see around major disasters. Earthquakes, mudslides, wildfires, even some vehicular accidents, can have people covered in nearly unimaginable layers of sweat, grease, dust, blood, crud, you name it. Even experienced EMTs have been caught flat footed. Some resorting to using NS from IV bags, drinking water, or water from nearby fire trucks after the normal supplies and bottled NS ran out.

Superglue is good stuff, within its limits, but it doesn't work well on greasy skin. On the other hand a small drop of glue between bandage and relatively clean skin will keep a simple wrap of gauze from sliding or rotating.

The acetone pads are sold as 'tape remover'. The cheap ones are, as I understand it, mostly acetone.

http://www.cnmtstore.com/index.php?itm=76441

Just a few drops per pad. No worries. Most cheap nail polish remover is mainly acetone. Used in tiny amounts it isn't really an issue. If you scrub and use several pads in on spot you might de-fat the skin and cause some damage. So gentle, gentle.

In recent years many hospitals have gone to less aggressive chemical compounds.

http://www.homecaredelivered.com/professionals/pc_product_detail.php?intItemID=4901

I don't know if they are as good for what I use them for. Worth a shot but they don't go into my kit without some experimentation.

Vicks has some uses but I don't think I would put it up my nose. Too close to delicate membranes. And don't get it in your eyes.

Also most commercial bottle water bottles can be used to irrigate a wound if you use the tip of a knife, or the awl on a SAK, to open a pinhole in the top of the cap. Good for irrigation, metering out water, and an effective squirt gun. Even better than the old standby trick of poking a hole in a plastic bag for irrigation because you can squeeze harder.

Why in the world are any of you using alcohol wipes for cleaning wounds?

They're not designed for that purpose, they burn, are painful on an open wound, can destroy or damage living tissue.

Use Benzalkonium Chloride wipes, they cost about 3 bucks for a hundred of them from any number of mailorder/website sources. They're usually larger than any alcohol wipe, they don't sting at all and they don't affect living tissue. Soap and water are even better or diluted iodine/betadine or some of the commercially available "wound washes" but if you're gonna carry something small in a FAK, do yourself a favor and get BZK wipes and leave the alcohol alone.

Alcohol wipes are meant to be used to disinfect unbroken skin prior to giving an injection, taking a blood sample or getting a blood glucose level.

As for making bandaids stick, after you clean the wound use some basic iodine or betadine either a swab or using a gauze pad or cotton ball and wipe it where you're going to put the bandaid, LET IT DRY, the adhesive will stick about a thousand percent better to skin treated with either iodine or betadine first.

Uh oh. I have been scrubbing my hands with betadine before surgery for years and never let it dry. I rinse my hands with water (tap water at that!), dry them, and then don gloves and gown.

Letting it dry is good because it leaves a bacteria resistant area, for lack of a better description, for hours, but iodine, wet or dry, will kill bugs.

A lot of this is all dependant on the question

"what do I intend this first aid kit for"

There is a HUGE difference between a "after disaster" kit, a "trauma" kit, a workshop kit (even a home workshop) and the classic "Mom with kids" kit - LOTS of overlap, and the bigger kits will be able to handle the lesser stuff, but

The other question is - How far/long (distance way less important than TIME) are you from regular medical care?

Many times when I was younger, I was a GOOD 12-14 hours walk without injury to the first telephone, and there was no such thing as a cell phone. Get hurt back were we used to go, and you were going to have fun. We "what if'd" some really possible scenarios like a broken leg/arm, and which way we would decide to go to get out. The real issue was the shortest HEALTHY way out would require two good arms, or some what to get someone up a 15-16ft rock face - You had to toe walk on a 4 inch or so wide ledge that went up this face, and you NEEDED to hold on - NOT something I'd want to do with an injured person. The problem is, the OTHER way out, without packs/packs stripped was about 25% longer time wise, and a LOT further distance wise

Our general conclusion was "stablize, and send team to get people to help" - the shorter way (the way with the rock face and a few other scrambles) could have a ATV/SUV get about 75% of that 12 hour walk distance - that first 25% though would probably require a litter, and some rope work to get a person with a broken leg out

So, the first aid kit for that would have to be "You better figure on 3/4 day or better before you get outside aid" - way different than when I gashed open my finger last year, and it was' OK, let's control the bleeding till I can get driven to the hospital 15 minutes away" - (4 stiches later...)

Your a little confused as to what I was getting at. I'm not talking about cleaning the wound. I'm talking about cleaning the skin around the wound so the bandage will stay put. Granted there is some overlap, soap and water is generally used to clean both wound and the surrounding area.

As you point out alcohol is justifiably restricted to the area surrounding the wound. It hurts like hell and damages the tissue. The later potentially slowing healing and increasing the chances of infection.

Benzalkonium chloride solution is, IMHO, fine for the surrounding area but used directly on the wound it might be less benign. Recent evidence suggests that the compound may not be entirely benign. Being both a potentially toxic and allergen. Simple soap and water is far safer.

Unfortunately tap water, or sterile water, and a little soap, is fine but in short supply in the field. Which is where the alcohol swabs, baby wipes, towelettes, and mommy spit come in.