Duct Tape Rx
A well‑stocked is one of the Ten Essentials, and on trips to remote areas, the scope of “first aid” necessarily broadens. When professional medical help is many hours (or even many days) away, canoeists and kayakers may be called upon to become medics, treating problems that would warrant a trip to the ER if they occurred at home.
Deep lacerations are a case in point. The paddlers’ world is full of sharp objects: knives, axes, mussel shells, coral, half‑submerged barbed‑wire fences, broken beer bottles… Any of these can slash open your tender flesh in less than a second, and no matter how careful you are, accidents do happen. Standard first‑aid is limited to stopping the bleeding (by direct pressure) and then protecting the wound with a gauze compress or similar dressing. That’s fine if you’re only a 15‑minute drive from the hospital.
But what if you’re kayaking in Arctic waters, the wind is blowing half a gale (and rising), and visibility is down to 100 yards, with little prospect of improvement in the next 36 hours? Or suppose you’re camping next to a beaver pond, two strenuous days of paddling and portaging from your car, in an area with no cellphone coverage. What then? You’ve got a deep open wound. And you need to close it. So… What do you do after you’ve stopped the bleeding?
Once upon a time, backcountry paddlers were encouraged to suture gaping wounds as soon as they’d been thoroughly scrubbed and debrided, and some wilderness medicine handbooks devoted several pages to the technique of stitching human flesh. But that advice has long been consigned to the museum of medico‑historical curiosities. A good thing, too. It’s difficult enough to clean a contaminated wound properly in a hospital setting. Doing so in a riverbank camp borders on the impossible. And stitching a dirty wound closed is asking for trouble — serious trouble.
Which is why the textbooks now suggest using wound‑closure strips (“butterfly bandages” or Steri‑Strips). These allow you to approximate the edges of the wound, thereby facilitating healing, while still leaving gaps for any purulent discharge to escape. But in my (limited) experience, neither butterfly bandages nor Steri‑Strips can be relied upon to keep a wound closed if the injured limb can’t be rested — as may well be the case if a paddler’s arm or leg is sliced open when he still has miles to go. In such cases, something more is needed. But what?
Well, how about …
It’s handy stuff, and most paddlers have a roll of this sturdy, reinforced tape in their repair kits. But duct tape is good for more than patching battered boats and torn tarps. It can also be used to mend a lacerated human frame. I didn’t dream this up by myself. I first learned of it from nurse practitioner and former British Army medic Chris Anderson:
Although living in the UK, whilst serving in the British Army as a medic I was canoeing in the Rockies around the Wainwright area in Canada some time ago. There was a fire ranger who took us for our survival training who was fantastic and thankfully put us in excellent stead in order to enjoy the wilderness for 10 days.
I remembered the lessons he taught regarding using what you have at hand in order to survive [the trek] back into civilisation, and to this end, I have been using and teaching the techniques he taught us regarding the closure of wounds using duct tape.
Surprised? I was. But I shouldn’t have been. Duct tape has a lot going for it. It boasts a tenacious, waterproof adhesive. And it conforms well to uneven surfaces, while still retaining a measure of elasticity. In short, it’s ideally suited to closing gaping wounds on active limbs.
Of course, you wouldn’t want to apply it directly over a gash. The adhesive would likely irritate the raw flesh, and removing the sticky tape later would almost certainly reopen the wound. But Chris let me in on the secret of using duct tape as a wound closure — safely. And now I’m passing the word along. So here goes:
How to Use Duct Tape to Close a Wound
I’m assuming you have the following items in your repair kit:
- Duct tape
- Stout, clean thread or a suitable substitute
Now let’s get stuck in. After stanching the bleeding and flushing the wound (use disinfected water and mild soap or detergent), proceed as follows:
1. Tear off two strips of duct tape. Three‑ to four‑inch lengths are usually enough. (If the wound is longer than the duct tape is wide, add more strips as needed. But three‑ to four‑inch lengths should still be adequate.)
2. Cut two lengths of stout thread, each one long enough to extend one‑half inch or so beyond the tape strips’ edges. These will be used to prevent the tension stitches (see below) from cutting through the tape and pulling out.
3. Place the thread on the adhesive surface of each strip of tape, roughly one‑half inch from one end, as shown in Figure A below. (The adhesive is colored pale gray; the tape’s outer surface, dark gray. The thread is orange.)
5. Next, stick the prepared tape strips to the intact skin on either side of the gaping wound. Make sure the skin is dry. (Since duct tape often employs latex‑based adhesives, think twice before applying it to the skin of anyone with a latex allergy.) The thread‑reinforced creases should lie close to the edges of the wound without extending beyond them (Figure D below).
6. Using more thread, place a running stitch between the tape strips, as shown in Figures E and F. You’ll need to double ordinary sewing thread, but button thread or any similarly sturdy stuff can be used just as it comes. Stop the end of the thread with a figure‑eight knot to prevent it pulling through, and keep the stitches in the doubled portion of the tape (its outboard edge is shown by the dotted white line). Take great care not to stick the needle point in your patient’s flesh. He’s suffered enough already.
8. Finish by tying off the working end of the thread. Now cover the closed wound with a light, sterile dressing.
Make a Brace of Duct Tape Wound‑Closure Strips in Advance
I made a couple of sets in a trice, and it was much easier to do on a table at home than on a muddy riverbank in a downpour. Each strip was fashioned as shown above, but the finished strips were subsequently stuck to squares cut from the plastic lid of a (now‑empty) can of ground coffee. I then placed the running stitch as already described, leaving a generous free end at the finish:
A heartfelt thank‑you to Chris, whose letter describing this ingenious wilderness expedient was the genesis of my article. Of course, I hope I’ll never have to use the knowledge I’ve gained in assembling my duct tape wound‑closure kit, but it’s good to know it’s there. Just in case.