yeah, that's usually OK. The problem is how sterile can you make it? Few wounds are clean. And "copious irrigation" is the name of the game. It's not unusual in the OR to go through 20 liters (that's 5 gallons!) of saline with an abdominal wound or a joint surgery.

Sterile 4x4 or 2x2 are fine, but again, you have to apply them "sterile." Sometimes we'll use iodoform, basically iodine-impregnated gauze. In other words, using sterile gloves and/or foreceps (or cotton-tip applicators, etc) that have been sterilized. And you should sterilze around the wound before you start, since you'll likely brush the gauze against the body as you put it in.

And contrary to some opinions, you don't have to really "pack" it in. I mean, you don't need to fit 50 gauze pads in a wound that's an inch square. The gauze should be put in gently, but when the wound is full, stop. Don't keep smashing gauze in tighter and tighter.

Then cover it with something sterile. Change it daily, or more if it's really pus'ing out. Watch for cellulitis. Depending on the wound, apply bacitracin/neosporin, sometimes silvadene (usually burns though), or just leave the top dry.

Would you expand upon this? When should I use topical antibiotics, and when shouldn't I?

Thanks to everyone, this thread has been a joy to read, and it has confirmed my belief that sutures is not high on the list of skills I need to learn




I don't know about "best", I focus on "appropriate", "quick" and "doable" with my skills and equipment and then let the doctors figure out the rest.

My plan of action in case someone has a serious wound is this:

- improvise a tourniquet if required (rarely needed outside battle zones, but when you need it you really need it). I don't expect it in a wilderness medicine setting. In a traffic accident the likelyhood of needing a tourniquet is probably higher, but still low.

- Close the wound as much as you can with your fingers and put whatever gauze / dressing material you have at hand on the wound. I always carry some sterile triangular cloth (multi-use item). If no sterile dressing is found, use the "cleanest available".

- Apply pressure.

- Wrap it all up with duct tape. Yes, duct tape. I won no scout's badge in bandage wrappings, so I do the best I can with the best I have at hand. No duct tape in the wound or at the skin next to the wound.

- Return to civilization.


I reserve those butterfly bandages for smaller cuts.

Glue? Nope, not for me - I'm not sure I have the "right" kind of super glue for medical use and I don't want to close a wound that may require re-opening.