Direct pressure to the wound is still the best way to control bleeding. By adding elevation, pressure bandage and if needed, the use of pressure points, most (99%+) of all bleeding can be controlled. Only < 1% would ever require a tourniquet. When controlling bleeding with direct pressure, opening the “gash” further is really not an issue. Once bleeding is controlled, under the appropriate medical setting and with correct wound care, closure of the wound can then occur. Pete