A severe wound is of major concern in a survival situation. If you are near an emergency room, odds are good that you would get such a wound sutured, resulting in ‘stitches’. This implies that having suture capability in your survival kit would be a good idea. But all is not as it might seem.
Consider that a severe wound has three areas of risk. First is that you could bleed to death in short order. Thus controlling bleeding is of primary concern, and there are more practical ways of controlling bleeding than just ‘sewing the wound closed’. Second is that the wound site becomes infected, which could result in death, loss of limb or at least a need for extensive medical care to cure. Lastly, if the wound does not heal properly, it could handicap you to some degree (limit your degree of motion). In the proper hands and with the proper equipment, suturing can minimize all these risks. In the hands of the untrained, without all the equipment, there is a fair chance it will not reduce the risks, and can even increase these risks.
Consider, closing a wound which has not been cleaned thoroughly is just begging for problems. So in addition to a suture kit, you would need a wound cleansing kit, sterile gloves and appropriate bandaging supplies. Which you probably should have anyway, when practical, and we will discuss this in a later article. Despite that scene in the Rambo movie, good suturing needs more than a needle and thread, or even a correct suture.
First, you need training in HOW to suture correctly. Classroom and lab is best, but difficult to arrange if you are not in a medical program. A good DVD may be adequate. Then there is practice, lots of practice. You can get ‘practice pads’, but they often are not cheap; various household, particularly grocery, items may suffice. As for equipment, the minimum is a needle holder, a pair of forceps and a pair of scissors. Although you can get a combination needle holder and scissors, known as an Olsen Hegar Clamp and you probably should go this route for survival medical usage. That way you don’t need a sterile surface to lay the third instrument on between it’s uses. Finding these instruments is neither difficult or expensive, unless you want them sterilized and sterile packed. Which you do. Then there is choosing WHICH sutures to get, and if you get differing types, which to use in each case. This requires some research. There are various materials sutures can be made of and various sizes and types of needles. Most do come sterile packed, but sutures for human usage have an expiration date. Is this a real problem? In a survival situation, perhaps not. Legal aftermath? Then it might be a real problem.
In Rambo, the hero sews his own arm up. Ignoring the risk of infection depicted here, there are two other problems. One is that what he does is ‘sewing’, not suturing. Can you suture with one hand? I doubt it, since correct sutures are actually a series of individual knots, eliminating the sideways force exerted by most continuous stitches. Why do you care about sideways force? At best, this can leave an ugly scar. Next, Rambo is presented as being able to take the prolonged pain of suturing a wound, but can you or someone in your party? Unless you have a lot of experience suturing, it is going to take you a fairly long while to complete the job, and so a local anesthetic is desirable. These drugs, and syringes, are somewhat controlled and may be difficult to get.
In case it is not clear, no, having a suture kit in your survival kit is usually NOT a good idea. Surgical closure strips (butterfly bandaids on steroids) are often a better choice for the non-doctor in a survival situation. If that does not appeal, perhaps a surgical stapler might be of interest. Quicker and easier to use than sutures, they can be operated with one hand, and most come as a preloaded, sterile package. Make sure you get an extra one to get used to before needing it for real.