Whenever you're in a survival situation, taking care of yourself and your family is one of the most important things you can do. And this is why it's so important to know what to do in scary but possible situations. The more you know, the better off you will be.

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 Most wounds you will encounter in an off-grid setting will be dirty. If you try to close a dirty wound, such as a gunshot, you have sequestered bacteria, bits of clothing, and dirt into your body. Within a short period of time, the wound will become infected. An infected wound appears red, swollen, and hot. In extreme cases, an abscess may form, and pus will accumulate inside. The infection may spread to the bloodstream, a condition known as “septicemia”, and become life-threatening.

It may be difficult to fight the urge to close a wound. Leaving the wound open, however, will allow you to clean the inside frequently and directly observe the healing process. It also allows inflammatory fluid to drain out of the body. The scar isn’t as pretty, but it’s the safest option in most cases. In addition, if you’re truly in a long-term survival scenario, the suture material or staples you have aren’t going to be replaced. It’s important to know when closure is absolutely necessary and when it’s not.

Other considerations when deciding whether or not to close a wound are whether it is a simple laceration (straight thin cut on the skin) or whether it is an avulsion (areas of skin torn out or hanging flaps). If the edges of the skin are so far apart that they cannot be stitched together without undue pressure, the wound should be left open.

Another reason the wound should be left open if it has been open for more than 8 hours. Why? Even the air has bacteria, and there’s a good chance that they have already colonized the injury by that time.

Let’s say that you’re certain the wound is clean. It’s less than 8 hours old. Here are some other factors that would suggest that closure is appropriate:

• The laceration is long or deep. The exception would be a puncture wound from an animal bite. These bites are loaded with bacteria and should be kept open in austere settings.

• The wound is located over a joint. A moving part, such as the knee, will constantly stress a wound and prevent it from closing in by itself.

• The wound gapes open loosely, suggesting that it can be closed without undue pressure on the skin.

t’s important to realize that you will only have a limited supply of staples and sutures. Feel free to mix different closure methods like alternating sutures and steri-strips, or even adding duct tape when you’ve run out of medical supplies. You’d be surprised what qualifies as medical supplies when the chips are down.

If you are unsure, you can choose to wait 48 to 72 hours before closing a wound to make sure that no signs of infection develop. This is referred to as “delayed closure”. Some wounds can be partially closed, allowing a small open space to avoid the accumulation of inflammatory fluid.

Drains, consisting of thin lengths of latex, nitrile, or even gauze, might be placed into the wound for this purpose. “Penrose” drains are a version of these that are still used in some operating rooms. Drains have a tendency to leak, so place a dressing over the exposed area

Many injuries that require closure (and some that don’t) also should be treated with antibiotics in oral or topical form to decrease the chance of infection. Natural substances with antibiotic properties, such as garlic or raw, unprocessed honey, may be useful in survival scenarios.

Not all wounds are the same, nor should they be treated that way. Let this serve as a guide to help you decide which wounds need a little more TLC before being stitched up. If you want to read the entire guide, check out Backdoor Survival for more.