By: Deborah Palmer

It can be tricky to determine when cuts and other injuries need the help of a doctor. Freedom Doctors, offers Mobile Urgent Care services and is here to help treat minor injuries. Most people get a paper cut or a skinned knee at some point in their lives, these minor injuries usually don't require any further attention, but what if a cut more serious? Certain injuries require stitches or more intervention for proper healing. How can you tell the difference?

At home care

For a minor cut you can most likely treat at home. So lets review basic wound care:

1. Clean the cut: Unless you cut yourself with a sterilized object (which lets be honest your kitchen knives are dirty) you're introducing germs into an open wound. Start by running a cut directly under tap water. You can use a small amount of hydrogen peroxide to clean a extra dirty wound, but this should be used sparingly as it can slow healing.

2. Stop the bleeding: Wrap in a clean cloth and apply direct pressure to stop bleeding

3. Apply dressing: Apply topical antibiotic ointment and .cover with a clean bandage. 

4. Monitor for infection

Do I need to see a doctor for further treatment?

If the wound is superficial, the edges of the wound stay together and you can stop the bleeding this will likely heal well on its own. If you're unsure whether you may need stitches, consult a doctor sooner than later.

Signs that you need to seek further medical attention

When choosing whether you need to seek further medical care things to think about include: mechanism of injury, location, size and depth of a cut, and risk of infection. When to seek help:

• Injury involving dirty, contaminated or rusty object (like stepping a rusty nail)

• Deep cuts - if a cut exceeds a quarter inch deep

• Bleeding not controlled through direct pressure and elevation (above the heart if possible)

• Visible fat, ligaments or bones

• Joint involvement

• Injury due to animal or human bite

• Concern for any foreign object(s)

Do I need stitches?

Although obtaining a medical opinion may prove helpful when determining if the wound requires stitches a few characteristics should be taken into consideration. The following should prompt you to seek medical attention:

• Deep cuts

• Gapping wounds

• Bleeding profusely despite applying pressure

Animal or human bite?

Bites are a special case, immediate medical attention is advised for further evaluated, as prophylaxis antibiotics are commonly prescribed to prevent infection. Rabies shots may also be a consideration.

Do I need a tetanus shot?

Tetanus shots are ideally given every 10 years, for most minor cuts if you had a tetanus shot in the last 10 years you're set. However, for some wounds including wounds contaminated with dirt, feces, soil, saliva having a tetanus shot within the last 5 years is advised.  If it's been more than 10 years (or >5 years in some cases) a tetanus booster shot is advised.

Stitches vs. Sutures

Although stitches and sutures are used interchangeably, they are essentially two separate entities. Sutures refer to actual thread used in the closure of wounds. Stitching describes the an actual closure technique.

Sutures, staples and glue; What’s the difference?

Suture, staples and wound glue are all ways to repair a cut; however, there are lots of factors playing a role in what your doctor will use to repair a cut.

Can I go to the Urgent Care if I need stitches?

Yes, an urgent care center or emergency department have the ability to stitch up a cut. Urgent care centers tend to have shorter waits and are cheaper than the emergency room. Freedom Doctors Mobile Urgent Care functions as urgent care with the benefit that medical treatment is provided in your own home.

What about wound glue?

Yes, if appropriate, wound glue can be used repair a cut.

How much does it cost to get stitches?

Cost for stitches in the urgent care is on average $200-$300, but this cost varies based on location and complexity of your injury.  The cost increases greatly if you have visit the emergency room. Freedom Doctors Mobile Urgent Care charges a flat fee for evaluation of a cut and stitches or glue for laceration repair if needed.

Best time to get stitches?

The ideal window to repair a laceration is <12 hours; fresh wounds are easier to repair, heal better, and are at reduced risk of scarring. Unless you can get into your PCP same day, the recommendation is an urgent care or emergency room.

How long do stitches stay in?

Timing of sutures removal is important. If they’re taken then out too soon there is a risk that the wound may open back up, but waiting too long increases risk of scarring. The train track appearance of the skin after suture removal is more common the longer stitches stay in place.  The timing of removal varies according to multiple factors, including location, shape and severity of a cut. Sutures may need to remain longer to ensure proper healing, ares of the body that have higher skin tension (overlying a joint) as wounds in these areas are at increases risk of opening up. If you have a deep cut you may require some dissolvable sutures under the skin to ensure proper closure, these will dissolve with time and do not need to be removed. 

Monitor for infection

Signs to suggest infection include spreading redness, worsening pain or pus, if concerned seek medical attention.

Aftercare

Once your wound has healed massage the scar with a moisturizer to help soften the scar. Apply sun protection.

Since kitchen knives are a major culprit for these injuries, you may be interested in some local history...

Are you familiar with the Dexter-Russel Cutlery, formally the Harrington Cutlery Company out of Southbridge, Massachusetts? The Harrington Cutlery Company was the first cutlery manufacturing company established in the United States, now well known for their high quality knives. When it was established in 1818 by Henry Harrington the company also manufactured surgical equipment, shoe knives and firearms.

Harrington Memorial Hospital which opened in 1931 in Southbridge, gets its name from the Harrington family which during the Great Depression made a large contribution that helped fund the construction of Harrington Memorial Hospital.   In 1933 when the Harrington Cutlery Company merged with the John Russel Cutlery Company, also out of Massachusetts, the name changed to the Russel Harrington Cutlery Company.  The name changed again in 2001 to Dexter-Russel Cutlery (Dexter reflecting the name of one of Harrington’s son Dexter Harrington for whom the Dexter line of knives was named). Dexter-Russel Cutlery is still in business today in Southbridge.

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