I'm putting together a little bug-out kit...part survival, part medical/first aid.

I'm probably going to get a couple of sutures/needles/needle holder.  I think.

Any docs/nurses/paramedics care to weigh in on this?

Recommended size for average lacerations?

How the heck do you do this to yourself of someone else without subcutaneous novocaine?

Are the 5% lidocaine topicals that are available over-the-counter going to do anything for the pain of a needle repeatedly going thru your soft tissue?  What's the alternative?

Is a skin stapler much easier? 

How does a skin stapler actually close up a laceration...let's say you get a 1 1/2" wide, 1/2" deep laceration across your palm or back of hand while using hatchet or knife?


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superglue and topical sutures - I don't think I'd bother with needle and thread unless you've had some practice.

+1 on superglue.

Sticking yourself together is generally not recommended - too much chance of sealing an infection in. Unless it's a real teotwawki situation it's not advisable. If you're preparing for that then get some real medical training.

Consider: 1. The kind of scalpel, needle, and thread are generally up to the surgeon. I'm sure for certain procedures and certain body parts, there are guidelines and recommendations, but these are questions on which not just reasonable minds but the best surgeons in the world can disagree.

2. The only time I've needed emergency medical care, my mother, a surgeon, had to call a nurse to assess whether I really needed stitches. I'm not sure an amateur could diagnose, create a treatment plan, and treat effectively.

You guys are expressing very logical thoughts and in general I agree with all of this. However, IF one were days away from any help and had a large wound, it would need to be treated. I have never and would not consider taking this approach if I or another injured party were merely hiking a couple of hours off the trail. Also, I'm not off my rocker; this is somthing that emergency medics have to be prepared for. In that vein, I'm seeking advice. Thanks.
I'm planning on taking my local Red Cross "CPR/ First Aid for Lay First Responders " course but as it's only two hours, I doubt they will cover any of this.
Can someone tell me more about topical sutures?

Tourniquet, you're not going to be giving yourself stitches. If the wound is severe   enough to the point of being life threatening then a tourniquet is the option you would take, otherwise pressure and bandaging. If you're eviscerated then you would cover yourself up with a moist bandage the best you can to keep the outside world from your used to be inside world and pray that you get definitive care in a hurry. There is no reason that you would have to give sutures to yourself and definitely no reason to even think about about giving any to anyone else. And no to superglue as well, that's a ridiculous idea.

This depends. Tourniquets are used to control a life threatening bleed. Dressings and bandages are used for smaller/slower bleeds. Eviscerations should be moistened and covered in plastic to prevent the wound from drying out, then secured with bandages. Sutures are great if you need to protect a wound for a prolonged period of time. In many ways sutures are like IV's. They are both ridiculously simple, the possibility of truly hurting someone is very minimal, and they both have almost no use in most emergency situations.

I've patched myself up many times in the field with super glue and carried it in my hit kit. Our medic carried super glue. So no, it's not a ridiculous idea. It's actually great for small stuff.

Superglue is not intended as a means to seal a wound, just because you medic thought it was a good idea doesn't make it right. Superglue isn't used in medical applications, there is medical glue but regardless if the wound requires stitching than you wouldn't use that due to the size of the wound and the possibility of getting the glue inside of the wound. If there is a high probability of contamination in the wound then you shouldn't seal that wound until you can properly decontaminate the wound and clean it thoroughly.

Gluing a small nick or paper cut is one thing gluing a severe wound is something completely different and telling someone it's ok to do so is not only bad advice bur irresponsible of you. Just because you saw someone else do it doesn't make it correct. Why not just tell him to carry gunpowder and cauterize the wound because you saw Dave Canterbury do it on tv, but I guess Rambo carried stitches in his knife too so what the hell do I know right.

And as to Sean O' and his statement for IVs in an emergency situation we push meds via IV, it's not just for hydration and the possibility of truly hurting someone by giving sutures is a real big issue, if you're sealing contaminants in that wound there is a damn good chance you're causing an infection...which is where that IV is going to come in handy.

Yup. I have been trained in surgery, anesthesia, and taught tactical medicine in at least 3 different countries not including the U.S. and am very familiar with IV's, sutures, tourniquets, etc.

For hypovolemia (most likely what we are talking about since we are talking about closing wounds) an IV is generally more harm than good because of the risk of diluting clotting factors, raising blood pressure, blowing out clots, and starting the bleeding process over. Other than that they are good for hydration and pushing IV meds. If treating hypovolemia I usually gain access and then set for TKO in the event I need to push drugs later.

Sealing contaminates in a wound is not really an issue as long as you have soap and water. It doesn't take anything fancy to clean a wound. I have performed hundreds (literally several hundred) minor surgical procedures on the tailgate of a pickup truck in the middle of nowhere.

For minor cuts (nothing deep or large) super glue can work in a pinch. Not my first choice by any means. I would prefer tincture of benzoin and steri-strips.

Ah I'm sorry I thought you meant IVs in general during an emergency situation.

I tend to agree with cleaning a wound with soap and water is all you need provided you have enough clean water on hand during your hypothetical prolonged survival situation the OP is inquiring about. Also I'm under the assumption that we're dealing with horrible catastrophic wounds from the OPs urgency to suture, I can't endorse anyone without proper medical training to perform suturing on themselves or anyone else. You mentioned how many minor procedures on the tailgate of a truck, you didn't mention how many you've performed in a clinical setting before you felt comfortable enough to do the field procedures, he isn't even CPR/First Aid certified I wouldn't let him anywhere near me...

I feel there is a definite difference between wilderness/survival medicine and clinical medicine. I actually have a lot more experience working in wilderness/austere environments than clinical environments, but can negotiate both when I need to. The basics save lives and I agree that a basic first aid course is much more beneficial than  any "advanced" procedures. I think that sometimes we make medicine a lot more confusing and scary than it really needs to be though.


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