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Needle Pulling Thread

+2 for the Duct Tape. My Pop was a Union Carpenter;Dockbuilder and they called it "Capenter's Bandaid". I used to carry very fine sutures and medium sutures with me all over the world, but they were for 3rd world doctors to use on me, rather than recycling their own.....
 
Duct Tape is easy to subdivide.. Double face it with a longer strip and a small square for blisters.. ( Sub moleskin) Nothing needs to be sterile if the skin is intact, That is one of my main uses..Another is to keep a bandage in place as its is far more tenacious than medical tape.

Yes if you are careful and clean the wound with alcohol and betadyne you can subdivide DT to make SteriStrips

In all the first aid kits IMO you need to have hand sanitizer.. If you have no open cuts on your hands the likelihood of catching anything is remote. OTOH if you have non sterile gloves the risk of transmitting something is possible.. Where have those gloves been? Sanitize your bare hands or the gloves if using.

I have hand sanitizer everywhere.. Usually negates the need for medication but if you are far from medical help you need to plan for more med supplies. I am always surprised by camp hygiene.. Some are better at it than others.. I am not very good at it but I am trying to be better
 
I have taken suture material with swaged needles, a needle holder, thumb forceps, scissors, and sterile gloves along with local anesthetic, and appropriate syringes and needles for administration of local anesthetic, on multi-day trips in which definitive medical care was likely to be multiple days distant.

I personally have not had great success getting steri-strips or butterfly closures to stick well in the field. The skin is often too wet, sweaty, bloody, etc. to get a good bond. There are liquid products available in small, single-use vials, such as Matisol or tincture of benzoin, which are available on Amazon and elsewhere. These are liquids that can be swabbed on intact skin along the wound margins and allowed to air dry before application of tape products, and will greatly increase the chances of getting a good bond.

Another product that is very useful for field dressings is some type of self-adhesive tape like Coban (sometimes called "vet wrap") that will keep extremity dressings better secured than conventional tape will.

Surgical skin staplers are not particularly difficult to use, and no-doubt easier to master than suture materials and instruments might be for the novice. But a skin stapler will require at least one additional instrument such as a fine-toothed thumb forceps which is used to approximate the skin edges. Staplers are much easier to use if there is an assistant armed with two fine-toothed thumb forceps to approximate and evert the skin edges for the person doing the stapling. A single person can use one-hand to approximate the skin, and the other to fire the stapler, but it is slightly tricky to get good skin approximation and it is an operation that is likely to frustrate the first-time user.


Whatever method of skin approximation you intend to use, a distinction must be made between clean-contaminated and contaminated wounds. No wound sustained in the field will be sterile, but some will fall into the clean-contaminated category. For example, someone lacerates themselves with a relatively clean (but obviously non-sterile) knife. If definitive medical care is not readily available for some time, I would close a clean-contaminated wound in the field. Heavily contaminated wounds are better treated by thoroughly flushing them out with sterile saline (if available), application of a topical antimicrobial agent, and dressing them open to be allowed to heal by secondary intent, or treated with delayed primary closure at a later time when definitive medical care is available.
 
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I think I've got you guys beat, I'm actually taking my own nurse. I met Nurse Bob about a month ago while back country skiing. He's a traveling nurse up here for temporary work and is looking for some adventure.

That's my approach as well! Met a travel nurse last month and I'm inviting her on a trip in September. I need her along because she's young, single, and attractive a capable first responder in the wilderness.
 
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