John:

This may help clear the "air" on Betadine.

Betadine (a.k.a. 10% Povidone-Iodine sol) should never be used "full strength" from the bottle into an open wound. In clinics and hospitals, it is always diluted further. The reason this is done is because "full strength" is still considered caustic to tissue. The only time it can be used directly is when the skin is still intact, e.g. prior to surgery and surface area needs to be cleansed. Iodine allergies also contribute to potential problems for some people, hence the hospitals are moving away from Betadine use to a degree.

Simple wound care should be done in the field if such care does not require evacuation of a patient.
Patients need to be evacuated if...

The wound is highly contaminated by debris.
The wound has a medium to large amount of crushed or dead tissue.
Any human or animal bite.
Deep wounds on the hands or feet.
Wounds requiring care for cosmetic reasons, such as, a laceration to the face.
A wound involving joints, or opens into a fracture. (Ankles, knees etc.)
Wounds associated with medium to large blood loss (uncontrolled bleeding > 10 minutes.)
Any gunshot or stab wound. This should be followed up with a police report.
The patient is limited in trip participation.
Any previously field cleaned wounds that are not healing correctly, or showing signs of infection.
Burns involving the head, face or trunk e.g. campstove explosion.
Environmental exposure will cause further complications, such as, hypothermia.

REMEMBER: Always error on the side of caution, if you are unsure whether someone should be evacuated or not, plan to evacuate.

Simple soap and water can be used for most wound cleaning, water clean enough to drink is clean enough to cleanse a wound. A minimum of 500mL (about ½ quart) should be used.

Betadine can be used as a cleansing adjunct, but only if diluted.

A good resource for more information is a book called “Field Guide to Emergency Medicine” by Dr. Paul Auerbach, M.D. and Dr. Eric Weiss, M.D. There are also the usual U.S. Military field manuals and survival books. Check your local library.

NOTE: These are common recommendations and I did not offer any recommendation for closing a wound in the wilderness setting.

Stargazer

ASAP= Always Suspicious, Always Prepared