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Wednesday, June 9, 2010

How to Treat and Care for Road Rash

Well, if you ride bicycles long enough or race them even a little, "how to treat and care for road rash" is a topic that should be addressed.

I should mention that I have a background in wound care.  When I served in the United States Navy, I was a hospital corpsman (medic) and laboratory technician.  As a result, I received training in basic wound care, and I have some associated practical experience treating these injuries, which has come in very handy after a few of my own crashes. 

It is important to act quickly after a mishap.  Being treated immediately can help stave off infection and shorten heal time.  If you are at a race there may be a first aid station/ambulance.  It is best to start here, especially because the medics are trained experts, and  the treatment and bandages may be free (care may not be compulsory).  If there is no first aid available, you should treat your wounds yourself as soon as possible.

  • First,  clean the wound.  Ideally the wound should be irrigated for several minutes with sterile saline solution.  If necessary, clean water sprayed from your water bottle can be used.  It is not advisable to use hydrogen peroxide or detergents on the wound, or to aggressively scrub the wound, these all can cause more harm than good, and can further damage cells and tissue.  Aggressive wound scrubbing may actually push microorganisms (primarily bacteria) deeper into the damaged tissues.   Do clean the unbroken skin around the wound thoroughly and gently blot/wipe the wound of major visible contaminants with a sterile gauze and some antiseptic wash (such as those pictured).  Don't overly worry about the wound being perfectly clean, because  (1) A healthy person's  immune system is very impressive and is literally designed for cases like this; (2) the wound will naturally self clean by oozing; and (3) the triple antibiotic ointment that you will be applying will provide an environment where the vast majority of bacteria can not survive. With that said, if your tetanus shot is not current (a booster shot should be given every 10 years), you should consider getting one.

  • Next slather a generous amount of triple antibiotic ointment on the wound.  This is very useful stuff.  It will help prevent infection, which is extremely important.  Additionally, it will help keep the wound moist, instead of scabbing over.  You do not want your wound to scab.  It takes longer to heal and will produce more scarring. Also the ointment will help prevent the dressing from sticking to the wound and as a result will make dressing changes much less painful. 

  • Finally, cover the wound with a sterile non-stick pad (such as shown).  You can tape the dressing or use tubular stretch bandage, which is ideal for elbows, ankles, and calves. Keep the dressings dry and change them at least once a day or whenever they become wet or dirty.  If they become wet or dirty, change the bandages as soon as possible, and always change your dressings after exercising.  

An alternative dressing is called Tegaderm TM, which is a semipermeable membrane dressing made by 3M.    Click this link for a full description of how to apply tegaderm.  It's bit of a hassle to apply properly, and works only on smaller rashes, but it reduces the amount of dressing changes. 
That's pretty much it.   Treating and caring for road rashes are no big deal, as long as you know what you are doing.  I would also suggest taking the recommended dosage for ibuprofen or acetaminophen  shortly after you are injured, especially before sleeping (see below warning).   It also helps a bit with the edema (fluid build-up; swelling) and/or inflammation associated with the trauma of the impact.

That being said, infection is a primary concern.  Seek immediate medical attention if you develop a fever.    If the wound begins to drain yellow or greenish fluid (pus), or if the skin around the wound becomes red, warm, swollen, or increasingly painful, your wound may be infected and you should seek medical care. Any red streaking of the skin around the wound may indicate that you have an infection in the system that drains fluid from the tissues, called the lymph system. This infection (lymphangitis) can be serious, especially if it is accompanied by a fever. Prompt medical care should be sought if you notice streaking redness from a wound. 

Note:  use ibuprofen or acetaminophen judiciously because these can mask (or hide) a fever. 

I hope nobody needs to apply this info either to themselves, teammates or friends, but if you do here it is.  Stay safe my friends!

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  1. Hi, I fell off my bicycle 4 weeks ago and got a bad graze on my palm. It is finally healing but it is still very pink, stings a bit and feels really tight. I get occasional shooting pains down my arm, too. It doesn't look infected. Is it ok for it to still be painful after 4 weeks? Is there anything I should be putting on it? I can't use my hand because of the pain still! Hope you can help. Thanks.

    1. Pieri21, Parts of the hand has thick skin and indeed can take more time to heal. My best advice would be to have a doctor check it out.

      I wish you a speedy recovery.

    2. Thank you. Doctors tend to just brush you off unless you're bleeding or dying! but I will get it checked out on Monday, anyway.

  2. thanks for the info. Got road rash on my knee falling off my was unbelievably painful for days...I was surprised how much suffering comes from road rash

  3. I got road rash on my leg when I crashed off my longboard going down a hill. I've been reading different things about how to treat it. It's on my calf right under my knee and my thigh right under my butt. It's pretty deep and it's scabbed over now, I've had it for five days. I'm oozing from it alot, it hurts, and my thigh keeps swelling when I don't take an ibuprofen. I just lost my job and am trying not to have to go see a doctor. I am a certified lifeguard and therefore am certified in first aid. I have been watching for signs of infection and don't see any except for the pain. I don't get a fever if I stop taking ibuprofen and the wounds are not hot or red around the outside. Is it normal to have it ooze, hurt, and swell still?

  4. Hello Anonymous: Please seek professional medical care. Your descriptions do indeed sound like infection.

  5. Yeah it is the precaution to make sure for avoiding with more infectious areas.
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