When I talk about duct tape with a wound, I'm generally thinking of either (a) using it becuase it's around and steristrips aren't, (b) as a form a dressing tape that actually holds something in place, or (c) as big bandaid with gauze over the wound, checked at every pause (or few hours if stationary) or if it gets painful.

The only other way I use it on me is for hotspots that I catch before they turn into blisters. Put down a little bit of gauze, and then a patch of duct tape. Or if I'm wearing dress shoes (which always blister my ankles), put it on before hand under the socks. :P

What I will say is, sutures are technically a minor surgical procedure. Not hard, but neither is putting in an IV. If you know how. If you don't, I can think of several ways you could make the wound more interesting trying to stitch. (Too shallow and it tears, don't keep it sterile, et al) And I'm sorry, you just won't learn that from a book or webpage. Take the blasted course and practice, or use strips or staples.

Or pray, if that's your thing.

15 yrs Nursing /10 yrs Wilderness Paramedic/Guide

If i were to pick one I'd go with 4-0 Eithilon
small enough for general , yet strong enough for larger needs.

Flotsam, since you appear to be the expert:

Can you reduce the pain by applying a anhestetic on the suture needle
(like Benzalkonium Chloride). Or does it take to long before it starts working?

Flotsam - what is your opinion on (1) the Israeli Bandage, (2) QuikClot, (3) using them in tandem?

This is HORRIBLE advice. Yes urine is sterile but it is a very very good medium for bacteria. So in essence you asking for any of the myrid of bacteria on your skin. So basically It wouldn't be very wise.
cheers

Get some tinture of Iodine solution and apply it to the area around the wound then use steri-strips. If you do not have the training etc then you should not be doing sutures. Also I do not know of any sutuation where sutures would be better then normal wound care in the field to justify suturing.
cheers

As several have stated in this thread and in several other threads; closing a wound in the field is not generally recommended, due to the risk of infection. With that in mind, I would steer clear of suturing in any case. Too tight and you run the risk of causing localized tissue damage and subsequent necrosis. Too loose and (on of the man reason to use sutures is to promote wound healing by primary intention-minimal scaring) and you will still have wound healing by secondary intention, which in the field is probably a better idea anyway (wound heals from the inside out, towards the surface-just leaves a bigger scar). If for some reason you must absolutely close a wound in the field, you need to make sure you have properly cleansed the wound, have oral antibiotics on hand. The use of Steri-strips or butterfly closures would be better to use, if you do not have the appropriate training.

Pete

I am far from being an expert, but I like to think I am a competent professional, and wound care is a large part of what I do on a daily basis.

Unfortunately, I have no experience w/ quikclot or the israeli bandage - we were still using the older style of trauma dressing when I was a medic. By reports, the Israeli dressing is quite good (and apparently there's a new version of the cinch-tight dressing that is getting good reviews as well). Quikclot - studies show that it does work, but the only study I've read involved a surgically lacerated femoral artery in a pig - I'd want to see a study w/ a truly traumatic injury (clean edges on vessels tend to seal much better than the ragged edges you would expect from a blast injury). Anecdotal evidence is mixed, from what I have read.

I wouldn't use urine as an irrigant. Aside from questionable sterility, it's also fairly concentrated & contains waste products - not something I'd desire to use as an irrigant.

ATOZ gave sound advice - If you don;t know what you're doing, you can make matters significantly worse by closing a wound. Benzoin & steri-strips can go a long way for minor wounds (this is pretty much all that I carry in my field first aid kits).

As for local anesthesia - applying anything directly to the needle is not going to work - lidocaine takes a few minutes to take effect under the best of circumstances. There have been reports of people using ice to numb the skin, or topicals such as oragel or hemmoroid cream -I have no experience w/ these. The only topical I've ever used is EMLA cream (a mix of prilocaine & lidocaine) - it takes a good while to take effect (around 30-60 minutes, IIRC), and it was not very good, in my opinion.

Again, the best advice - clean it as well as possible, remove any obvious debris, irrigate w/ the cleanest (potable) water you have, bandage & monitor. The human body can be incredibly forgiving (I often conclude that it heals inspite of what we do, rather than because of what we do). If you want to have extra tools in your toolbox - get some proper training. Unfortunately, this is not something easily picked up frm a book - it requires hands-on training & experience to become competent.

I don't carry water often, and when I do am often thinking more of its first aid uses than drinking it. One thing I've been wondering about recently: is water significantly dirtier if it comes out of a water bladder and/or drinking tube, like a Platypus, rather than a bottle?

I'm not disagreeing with you. I just didn't want people to think duct tape etc. is a suitable long term dressing. I have to admit to using electrical tape to close a nasty gash until I got to the doctor for stitches.

And you are right about learning to suture up a wound, it's not rocket science but practice is definitely the best way to learn to do well.