Lidocaine gels and other simillar penetrate skin up to 5 mm. It works with vaccine injections with small children. Also mostly for inplementation intrevenous cathtters. But for wounds it will be probably not enought.

We use it routinely - we call is LET (lido, epi, tetracaine).  It's placed in triage by the nurses.  We only use it for open wounds (not for IV placement) for which it works best.  It's great- occasionally it can be used alone- one or two sutures but most of the time we use it as a "gateway drug."  It makes placing the injection of lidocaine easier.  You know it has taken effect because the skin will become paler from the epinephrine effect.

Our protocol does not allow for its use on fingers, toes, nose, or penis- although most research (or lack there of) suggests this doesn't matter.

You need to place a type of gauze over it that won't absorb it- i.e. 4x4 will but webril/cast padding won't.  One important part is that you need to place a pressure wrap over the dressing as this helps with absorption into the skin.

Good luck

We are hoping to trial LAT gel in our department for children with wounds usually requiring conscious sedation or GA to close lacerations, but also to thoroughly clean large abrasions. Do you have any upto date evidence that you could offer please