View Full Version : Road Rash, how to treat it...

02-09-2008, 09:17 AM
It seemed that this info should appear somewhere on the site (especially since I've linked to it twice this week)...

The following was taken from Bicycling Magazine (http://www.bicycling.com/article/0,6610,s1-4-22-1041-1,00.html)'s website. The original article has since been taken down... Glad I archived it.

The Crash-Rash Crash Course
Think you know what to do after a crash? Take this quiz to find out. Even the best of us takes a digger every 4,500 miles, according to the Bicycle Helmet Safety Institute. Do you know exactly what to do when a big section of your skin ends up on the road instead of on your body? You might think so--but if you don't know all the answers to our handy quiz, you may be risking infection, extended healing time, unsightly scars and endless repetitions of your stupid crash story to curious questioners.

1. Squirt the wound with water right away.
True. Flushing helps remove the dirt that is ground into your flesh. Use your water bottle or hydration pack. To get more pressure from your pack, remove the bladder from the backpack, hold it under your arm and squeeze it against the side of your body. If you have a sports drink or soda but no water, use the two-hour rule: If you'll be home within two hours, skip the flush. Longer: Use what you got. Sugar hitting raw flesh hurts dang bad--but it beats a pus-oozing infection.

2. Scrub the bejeezus out of the abrasion as soon as you get home.
No. First, soak the owie. After at least 10 minutes of immersion, it'll be softer so your scrubbing is more effective. And, if the abrasion is on a part of your body you can wave back and forth (like your arm) some of the grit will get carried out by the flow of water. Running water--holding your arm under a faucet--doesn't work as well even though there's more force; you generally get tired of the irritation before you're thoroughly moisturized. And, anyway, the point isn't to get grit out yet--it's to soften your skin for the real job: scrubbing.

3. Scrubbing hurts.
Yes/ #%$@+&% right it hurts!
#%$@+&% right! It hurts a lot. In fact, our survey of crash victims found that nearly three-quarters of us lack the huevos to scrub hard and long enough to remove all dirt ourselves. Recruit someone to grate your tender body. A toothbrush or a clean, soft shoe-shine brush works better than a washcloth. You're done when the wound is bright red over its entire surface area and unmarked by black spots. Don't start digging with tweezers or scissors--if scrubbing can't remove embedded grit, it's ER time. You should also go to a physician if you know you're a weenie. You feel like a wimp sitting in the waiting room next to a guy holding three detached fingers, but humiliation is worth the joy of a topical anesthetic and a pain-free cleanup.

4. Quick to Scab = Quick to Heal
Negative. Scabs prevent healing oxygen from reaching the wound.
Here's how to cut your healing time in half-and avoid most scars:
* Apply a topical antibiotic ointment (such as Neosporin) and cover with a bandage.
* Two to three times a day, wash the wound gently with water, then reapply ointment and a fresh bandage. Do this for 5-10 days.
* Many pro riders use this quick-heal combination--it's labor-intensive and expensive, but it works well: ointment covered by a "wet" bandage originally developed for burn victims (such as Second Skin or Tegaderm (http://solutions.3m.com/wps/portal/3M/en_US/WW_Nexcare/FirstAidProducts/Products/FirstAid/WoundCare/?WT.srch=1&WT.mc_id=SE_NCB_exact_tegaderm&gclid=CJD_6LeQ36cCFYjsKgodW1L9-w), available at drugstores). Cover with a gauze bandage, then wrap with a reusable elastic bandage (instead of tape). Or you could try "tubular elastic gauze" (it slides over your arms like a sleeve); it's not available in most drugstores, but you can get it through medical supply stores or hospitals.

5. After a couple days, surrounding redness or red streaks radiating from the abrasion mean a trip to the doc--or losing an arm to gangrene.
Yes. But redness isn't the only sign of infection. Fever and nausea can also signal a haywire situation. And if you're bruised under the rash, get to a doc right away. This combo can lead to a systemic infection when the abrasion "communicates" with the underlying pool of blood (which is what a bruise is). This can turn into scar tissue or calcify, producing pain and limited range of motion. Nasty, huh?

How to Help An Infection Thrive
You auger in. Flush with water. Scrub. Smear ointment on. Next day you feel better and don't bother with the mess of applying ointment. Three days later, your abrasion gets hot and red--infection. So you apply ointment. You're actually making the bacteria in your wound resistant to medication, says Bruce R. Canady, of the American Society of Health-System Pharmacists. "If you toy with germs, they're harder to kill," he says. Apply medication continually and regularly for at least 5 days.

You Probably Need Stitches If...
Road rash is a surface abrasion treatable with scrubbing and ointments. A puncture or open wound requires a sew-up if it:
* Is one-quarter inch or more deep
* Has ragged or gaping edges
* Is in an area where you're concerned about scarring--such as your face, palm, a joint, eyelid or lip
* Is still bleeding strongly after 15 minutes of direct pressure
* Reveals bone or muscle

Rubberside Down!

02-09-2008, 07:40 PM
Good information to have. I think one of the biggest mistakes that people make with significant wounds of any kind is after a day or so it looks fine, because they were very meticulous with cleaning it, so they stop treating it and then infection sets in. Just like with antibiotics, keep taking until the prescription is out, as per doctors orders:D

My favorite was when I was 8-10 years old or so and wiped out hard while jumping on a freshly paved lot. It still had the sand spread out, hence the crash (live and learn!). Took a nice chunk out of my left knee. Instead of scrubbing it several times a day, my Mom would use a dental water pick. I'm know it was very effective and possibly less painful (??) than scrubbing, but maaaan I HATED that damn pick after that and never used it again! At 34 I still have a good silver dollar sized scar.


the Wumpus
02-10-2008, 11:52 AM
Something I've done is to print out the immediate first aid steps and keep them with my stash of first aid goodies where I know I'll find them if I should need them. It's good to have a list of steps handy for times like this, even if it's easy, basic stuff.

Also means I don't have to look too closely at the description when I don't need to. I don't have any trouble actually taking care of an injury, but thinking about doing this stuff when I'm perfectly fine brings out my inner sissy.

02-19-2008, 02:13 PM
Mike Murray has a nice little guide up over at OBRA, too:

Tegaderm is where it's at. You'll heal faster, cleaner, and with less hassle than a conventional bandage. I keep some in my first aid kit at all times now - it's totally indispensable. As a bonus, it's transparent, which makes showing off your battle scars to squeamish coworkers much easier.

06-09-2011, 02:05 PM
As a self professed evangelist of this type of bandage (I get DuoDerm extra thin from Beaverton Pharmacy) I must disagree about any ointment between the skin this type of bandage.

If you aren't going to sterilize the wound with betadine or iodine or something with similar efficacy you might just as well not waste the money on this more expensive type of bandage.

It is intended to go on a dry surface; as the wound becomes moist, after sterilizing and drying, the adhesive turns in to a non-adhesive cushion. The outside surface maintains a high vapor permeability while repelling water and maintaining a sterile field.

David Henderson
06-07-2012, 11:53 AM
I've written an article on treating road rash that could be valuable information for some. It's not significantly different than the "Bicycling Magazine" version pasted above, but includes a few pictures and some additional information regarding tetanus vaccination, and some additional information on signs of infection and most importantly how to prevent them. Also triple antibiotic is potentially more effective for suppressing bacterial growth than just Neomycin Sulfate alone (producing drug resistant bacteria from using topical antibacterial ointment generally shouldn't be considered when treating one's road rash..... )

How to Treat and Care for Road Rash (http://myworldfromabicycle.blogspot.com/2010/06/how-to-care-for-or-treat-road-rash.html)

David Henderson