Burns & Lacerations

Cuts and burns happen fast. The decision that matters most is where to take them. About 90% of cuts and minor burns can be fully treated at urgent care, faster and at a fraction of the cost of an ER visit. At Good Health NC in Knightdale we are set up to handle:

• Lacerations (cuts that have gone through the full thickness of skin) that are clean, controllable, and less than about 4 inches long
• Avulsions and skin flaps that can be approximated and closed
• Punctures from nails, glass, splinters, and animal bites (with appropriate cleaning and tetanus update)
• Abrasions and road rash requiring thorough cleaning and dressing
• First-degree burns (red, painful, no blisters, like a typical sunburn)
• Second-degree (partial-thickness) burns that are small, away from the face, hands, feet, joints, and genitals
• Friction and contact burns from cooking, hair tools, and small chemical splashes after immediate decontamination
• Tetanus boosters when indicated for any wound

For cuts that need stitches specifically, our suturing and wound care page goes deeper on closure technique, suture removal, and aftercare.

This is the question we get asked most. Here's the clinical answer.

Come to Good Health NC urgent care for:

• Cuts where bleeding is controllable with direct pressure
• Lacerations less than about 4 inches long
• Burns smaller than your palm that are first- or second-degree, not on the face, hands, feet, joints, or genitals
• Wounds without exposed bone, tendon, muscle, or joint capsule
• Animal and human bites that are not on the hand or face and don't involve deep puncture
• Sunburn with limited blistering

Go directly to the ER (or call 911) for:

1. Any third-degree burn (white, charred, leathery, or painless skin)
2. Burns covering more than 10% of body surface area (roughly the size of one arm)
3. Burns on the face, eyes, hands, feet, major joints, genitals, or that go all the way around a limb
4. Inhalation injury (singed nasal hair, soot in the mouth, hoarse voice, smoke exposure in an enclosed space)
5. Electrical or chemical burns
6. Deep puncture wounds, especially to the chest, abdomen, neck, or eye
7. Lacerations with bleeding that won't stop after 15 minutes of direct pressure
8. Wounds with visible bone, tendon, deep muscle, or numbness/weakness past the injury
9. Severe crush injuries or amputations

The American Burn Association's burn referral criteria is the standard we use to decide whether a burn needs a burn center. When in doubt, call us first.

Stitches are time-sensitive. Most lacerations should be closed within about 12 hours of the injury (24 hours for face wounds, sometimes longer in clean wounds). The longer you wait, the higher the infection risk.

Here's what happens at our Knightdale clinic:

1. Bleeding control and exam. We hold pressure if needed, then carefully evaluate depth, contamination, and whether any underlying structures (tendon, nerve, vessel) are involved.
2. Local anesthetic. Lidocaine, often buffered to reduce stinging, numbs the wound before any closure.
3. Cleaning and irrigation. This is the most important step. We thoroughly clean the wound with sterile saline, remove any debris, and explore for foreign bodies.
4. Closure. Depending on the wound, we use sutures (stitches), staples, skin adhesive (Dermabond), or wound closure strips. Face wounds get the finest sutures to minimize scarring.
5. Tetanus update. If your last tetanus shot was more than 5 years ago and you have a dirty wound, or more than 10 years ago for any wound, you get a booster.
6. Dressing and aftercare. A clean dressing, written aftercare instructions, and a follow-up plan for suture removal.

Suture removal timing: Face 5 days, scalp and trunk 7 to 10 days, arms and legs 10 to 14 days, joints 14 days. We schedule this for you before you leave.

Burns require a different approach than cuts. Our process:

1. Cooling and pain control. If you haven't already cooled the burn, we do so with room-temperature water (never ice, which causes more damage).
2. Depth assessment. First-degree (red, painful, no blister) heals on its own. Second-degree (blistered, weeping) needs careful management. Third-degree (white, charred, no pain) goes to a burn center.
3. Cleaning and debridement. Loose blistered skin may be carefully removed to allow proper dressing. Intact blisters are often left in place.
4. Dressing. We apply a non-adherent dressing with an appropriate burn ointment such as bacitracin or silver sulfadiazine.
5. Pain plan. Most burns are surprisingly painful. We address this directly with appropriate over-the-counter and short-course prescription options.
6. Follow-up. Second-degree burns are rechecked in 48 to 72 hours to assess healing and infection risk.

The American Academy of Family Physicians' outpatient burn management guide is the framework we follow.

Don't wait if any of these apply:

• The wound was caused by something dirty (rust, soil, oral cavity, manure) and your tetanus is out of date
• You can't tell how deep the cut is or whether you can feel and move normally past it
• The burn is over a joint, the face, hands, feet, or genitals
• Redness, swelling, warmth, or red streaking develops around the wound (signs of infection)
• The wound starts producing thick or foul-smelling discharge
• You develop a fever after the injury
• You have diabetes, take immunosuppressants, or have any condition that slows wound healing

Diabetic patients especially should not wait on wounds or burns. We pair urgent wound care with chronic disease management in the same clinic, so diabetes care and wound healing can be coordinated together.

Three reasons patients in the Triangle choose us for cuts and burns:

• Time. Most urgent care visits for a laceration or burn are under an hour, compared to 3 to 6 hours at a typical ER.
• Cost. Urgent care visits typically cost a fraction of what the same care costs in an emergency room, both for insurance copays and cash pay.
• Continuity. If the wound needs follow-up, suture removal, an infection check, or scar management, you see the same clinical team. If the injury reveals an underlying issue, like a fall caused by a blood sugar drop, we move directly into chronic condition management without a separate referral.

Walk-ins are welcome at our Knightdale location, and we always reserve same-day appointment availability for injuries.