So you cut yourself in the field. Now what?

[Tony Trietch]

Zip Stitch
Well this might be going in my pack..

 

[kipper09]

Zip Stitch
Well this might be going in my pack..

I just learned of this as well. This will be going in my pack.


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[willfrye027]

Here’s the reasons you don’t want to close a wound in the field.

Bacteria cause infections. Certain species of bacteria need air to thrive, others can only thrive in the absence of oxygen. Some of the nastiest bacteria in terms of soft tissue infections are of the kind that need an environment without oxygen. In nature, these suckers live in the dirt among other places.

If you come to the ER with a big cut, the most crucial step is copious irrigation with sterile water. Usually a minimum of 1L of water is forcefully squirted in the cut to wash out as much dirt or bacteria as possible. Then, depending on a variety of factors including how long ago the injury was, is it a high risk wound (dog bite for instance), and other factors they may or may not decide to close it with sutures (or glue). There is a risk/benefit at play—the risk is sealing in dangerous bacteria that can thrive in a closed off wound, but otherwise would not have caused problems if the wound was allowed to heal from the inside out. The benefit of sutures? Primarily cosmetic. Really guys, it comes down to a cosmetic benefit (which you are unlikely to capitalize on in the backcountry) and a risk of infection which could kill you (ie gas gangrene, which can come from bacteria that live in the dirt). Alright stepping down from my soap box.

 

[Akwoodchuck]

Here’s the reasons you don’t want to close a wound in the field.

Bacteria cause infections. Certain species of bacteria need air to thrive, others can only thrive in the absence of oxygen. Some of the nastiest bacteria in terms of soft tissue infections are of the kind that need an environment without oxygen. In nature, these suckers live in the dirt among other places.

If you come to the ER with a big cut, the most crucial step is copious irrigation with sterile water. Usually a minimum of 1L of water is forcefully squirted in the cut to wash out as much dirt or bacteria as possible. Then, depending on a variety of factors including how long ago the injury was, is it a high risk wound (dog bite for instance), and other factors they may or may not decide to close it with sutures (or glue). There is a risk/benefit at play—the risk is sealing in dangerous bacteria that can thrive in a closed off wound, but otherwise would not have caused problems if the wound was allowed to heal from the inside out. The benefit of sutures? Primarily cosmetic. Really guys, it comes down to a cosmetic benefit (which you are unlikely to capitalize on in the backcountry) and a risk of infection which could kill you (ie gas gangrene, which can come from bacteria that live in the dirt). Alright stepping down from my soap box.

True this....I shred my hands pretty often at work ( construction)...if the bleeding is copious, I just tape it...duct tape, shur tape, blue masking tape, electrician's, whatevers around, just not too tight. When bleeding stops, soak in sterile warm water to clean. Most importantly, be healthy in the first place...so eat your veggies

 

[blackdog]

Anybody carry an Israeli bandage? At 3oz, this looks like it could be a very beneficial piece of first aid to keep in a kit.
Israeli Bandage Battle Dressing

 

[CrzyTrekker]

scars are good

 

[Stingray]

Anybody carry an Israeli bandage? At 3oz, this looks like it could be a very beneficial piece of first aid to keep in a kit.
Israeli Bandage Battle Dressing

An ace bandage and compressed gauze will provide same capability and be more flexible. Israeli bandage is good for many wounds but isn’t perfect.

 

[BeastOfTheTrees]

Have done the military TCCC course several times and take a refresher regularly. In my opinion it doesn’t matter what you carry if you can’t use it. In fact, if you have the right training and some supplies you can stop and arterial bleed. I’ve done it. It isn’t easy. But it is possible.

In my possibles I carry a CAT 7 tourniquet, a quick clot sponge (powder is hard to use - imagine pouring cool aid drink mix onto a garden hose, same concept with a strong bleeder and using the powder), two small compressed gauze packages, two rolls of ace bandages, some tape, a burntec dressing, antibiotic ointment and some various little add ones depending on where I’m going. Sometimes I carry a complete IFAK if I think it might be needed. My usual kit weighs 1-1.5 lbs and I can treat everything from small cuts to a serious bleeder or even a broken bone long enough to get help.

I always grab extra IFAKs from our medic specifically to take into the backcountry

 

[MichaelO]

Stop the bleeding. Have been in a situation where I lost a lot of blood due to lacerations on my hand and it’s really hard to self rescue if you loose a lot of blood.

I now keep ifaks in all my vehicles and one on me in the field, preferably on the outside of my bag or in my cargo pocket. I don’t want to have to dig for it if something bad happens with a knife or a broad head.

 

[Stingray]

Stop the bleeding. Have been in a situation where I lost a lot of blood due to lacerations on my hand and it’s really hard to self rescue if you loose a lot of blood.

I now keep ifaks in all my vehicles and one on me in the field, preferably on the outside of my bag or in my cargo pocket. I don’t want to have to dig for it if something bad happens with a knife or a broad head.

Couldn’t agree more. I keep IFAKs or similar everywhere; vehicles, home, office, travel bags, hunting bag, etc.

 

[MtnOyster]

Rub dirt on it

 

[Wentworth6]

In my first aid kit is a surgical stapler. It’s light. I have not used it on myself but have on 2 dogs in the past where their wounds were severe. It is fairly light and anyone could do it.

 

[ID2NM]

Sterilize then Vet bond glue and duct tape assuming its not too deep. If its deep get a hospital, infection is nothing to screw with.

 

[Arrowslinger]

While removing the skull from a buck, I managed to bury a Browning Kodiak knife into my thigh. The blade was 3" and it plunged straight in. I packed, covered and elevated my leg while my buddy finished up the deer and we both packed it out. I could feel the muscle rip a bit during the hike and 33 stitches later I have a deformed quad and about 10" circle of numbest in my leg from nerve damage. You now see me go real slow with a knife in my hand.

 

[Mike7]

When I do even carry cut stuff, I carry 4x4's for bleeding control and to use for wet scrubbing of really dirty wounds, tape, steristrips with benzoin crushable capsules, a tiny leatherman squirt that has tweezers and scissors, and regular filtered drinking water for wound irrigation/scrubs.

This is very light compact stuff and there are very few things that can't at least be taken care of temporarily with the above items and knowing how to put adequate pressure on a wound. Just stay calm and maintain firm steady pressure.

I have a lot of experience, so I personally would approximate or close "without sutures" most all wounds in the field, at least temporarily, with the above items....except a deep wound in the pretibial region extending to or close to the bone. This is a relatively avascular area with bone right under the skin, giving the possibility of developing a bone infection in some cases after permanent field closure. You can however do a 4x4 wet to dry dressing on this type of a cut after field cleaning and then consider later closure out of the field, or just let it heal in by secondary intention.

Another complicated area is hand wounds with exposed or cut tendons...Irrigate well and approximate skin edges temporarily, because the wound may be reopened and cleaned/repaired later at the hospital.

 

[ShariVari]

It's strange, but when I cut my finger for example I IMMEDIATELY push the cut down very strong for a half second, then the blood will disappear from that area, and when you lift up your finger from the cut, then you can see the cut without blood. Then again put your finger to the cut very strong for 4-5 mins, then sterilizing, then push again for 3-4 min. And at the end you doesn't even need to wrap it, cause the blood will completely disappear, only you can see is the cut's line. But it works only if the cut is not very deep.

 

[Sticknstring]

get wilderness first aid certed or WFR, especially since your guiding. AND incase a negligent discharge ever took place. backcountry medical guides are legit and teach courses near you in California. They will teach you how to keep someone alive and extract and or till rescue, this includes building improvised valves for gunshot or puncture wounds to the chest. as far as cuts go....irrigate the hell out of it with water, any water but clean is ideal, THEN bandage...if its arterial and spurting then just direct pressure. The biggest concern for most cuts is infection, alcohol and disinfectants have been proven to do more damage than good (again, anyone who's been certed recently in first aid will know this, not harping on you or anyone...just that its the new protocol). So yeah, only fresh water and a clean dressing, use a water bottle with a hole poked into the cap to irrigate (lots of pressure is needed for gnarly cuts so the water bottle trick works if you don't have a common irrigation syringe in your kit). pressure for lots bleeding, if you can't stop the bleeding then tourniquet...military says they can be left on for over 12 hours without damaging the limb but they should be loosened and checked every 2 hours (to see if clotting took place and to aid in less of a chance of amputation later on)...improvised tourniquets should NOT be made from belts or paracord (unless you want to amputate them then and there ...jus kidding, but don't use those, even recently in the Vegas shooting ER docs wrote about how the belt tourniquets did NOTHING)...use the bottom of a T shirt tied in a loop knot of some kind with a windlass/stick to tighten till pulse disappears....hope that was helpful, and I'm sure I went way overboard...but that's what a professional survival guide and backcountry guide it supposed to do right? haha.

 

[ColeyG]

Here’s the reasons you don’t want to close a wound in the field.

Bacteria cause infections. Certain species of bacteria need air to thrive, others can only thrive in the absence of oxygen. Some of the nastiest bacteria in terms of soft tissue infections are of the kind that need an environment without oxygen. In nature, these suckers live in the dirt among other places.

If you come to the ER with a big cut, the most crucial step is copious irrigation with sterile water. Usually a minimum of 1L of water is forcefully squirted in the cut to wash out as much dirt or bacteria as possible. Then, depending on a variety of factors including how long ago the injury was, is it a high risk wound (dog bite for instance), and other factors they may or may not decide to close it with sutures (or glue). There is a risk/benefit at play—the risk is sealing in dangerous bacteria that can thrive in a closed off wound, but otherwise would not have caused problems if the wound was allowed to heal from the inside out. The benefit of sutures? Primarily cosmetic. Really guys, it comes down to a cosmetic benefit (which you are unlikely to capitalize on in the backcountry) and a risk of infection which could kill you (ie gas gangrene, which can come from bacteria that live in the dirt). Alright stepping down from my soap box.

Good advice. If you are planning to permanently close a wound up in the field, be darn sure you've done a good job of irrigating it with sterile water. Irrigation under pressure with some sort of anti-bacterial scrub is ideal.

If you plan to go to the ER and get it closed up, most docs won't close wounds that have been open for more than 8 hours. At that point the healing has begun and the wound won't close properly even if sutured or stapled. If you've closed in the field then go to the doc, they will likely re-open it and clean it out then lock it back up.

 

[Beckjhong]

Good advice. If you are planning to permanently close a wound up in the field, be darn sure you've done a good job of irrigating it with sterile water. Irrigation under pressure with some sort of anti-bacterial scrub is ideal.

If you plan to go to the ER and get it closed up, most docs won't close wounds that have been open for more than 8 hours. At that point the healing has begun and the wound won't close properly even if sutured or stapled. If you've closed in the field then go to the doc, they will likely re-open it and clean it out then lock it back up.

Yup. I’ll go 12-24h based on history and location. I’ll offer that wounds are generally closed for: stopping bleeding, improving cosmetic outcome, and improving wound healing (mostly in the setting of significant tissue deficit).

For the layperson that has a wound and they are dead set on staying in the field, how about pressure and bandage to stop bleeding, and changing bandage twice a day/as soiled?


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[pdxmatt]

I take a cut proof meat cutting glove in the field, wear on my off hand, use in the butcher shop, saves a lot of injuries in the workplace, no weight in pack, few bucks and covers the most common cuts cleaning game.

That being said, quick clot, gauze, Med tape should fix most issues.


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Dig the cut proof glove idea. I cut myself once nearly every year in the field no matter what knife I'm using. Last year I cut myself butchering an elk solo and it was hard to slow the bleeding. I always have a first aid kit but I plan to beef it up before next year. The glove may be the simplest solution to this.