The sutures are something that I have (unfortunately) had a lot of experience with and they work so well. Granted, duct tape works well too but the sutures are sterile. As far as why they are in the small kit, well basically it was just because they take up such a small amount of room (about as much or less space than a small paperclip) and I had the extra space and nothing else to fill it that wasnt either less useful or too big. Even a single piece of tinderquik or a single MP1 tab would take up significantly more space.