Bad Road Rash & Residual Grit

Those of you that have wiped out bad, how long did you have those residual pieces of dirt, sand, grit etc. trying to work their way out of your flesh? :confused:

I posted about my recent crash...

http://forums.teamestrogen.com/showthread.php?t=33852

Omg... this sandy grit trying to work it's way outta my face around the eye socket and check bone is so awful. It hurts so bad. Itches. I'm trying not to mess with it. Some sand coming out provides relief. However, only MORE creeps right back in the same spot.

I thought this area was OK. But, I am having my MRI for my neck and separated shoulder acl soon. So, I was massaging this area trying to feel for what seems like a piece of broken sunglasses frame left in the corner of my eye. I'm sure my Rudy's have no metal materials. However, it was just worrying me with the MRI magnet etc. That's when all this sand started re-surfacing.

When is it gonna quit?:( *sigh* (btw, been a couple weeks now)

When I was about 10 years old, I wiped out badly and pulled out bits of gravel for years. The last little piece of gravel worked its way out of my knee when I was 18. No kidding. My parents didn't believe in going to the Dr. and whenever my siblings and I got a foreign body in our skin they'd tell us to just "let it fester out." Usually, things would fester out much more quickly.

I'm a nurse now. If you've been to the Dr. and they've got out all they can under sterile/clean conditions, you ought to leave it alone and not pick at it until after all the swelling goes down. You don't want to give yourself an infection.

My friend that's a nurse in a Denver trauma center says that they use spray and wash to clean up road rash at work - for motorcycle or bike riders. She says it's the gentlest & best method they've found.

I had festering blisters from the road rash for weeks - a result of an allergic reaction to the sand/dirt and the polysporin I put on it initially. It was nasty and itchy...

Thanks for those replies thus far.

Oh, I wish they would have irrigated it the ER. I can remember the RN using the tweezers to pick out the jersey threads from my back. But, she just wiped my face over once with a piece of gauze and a cleanser.

When I was home, I could see the grit in the wounds. But, I wasn't sure how much was flesh, and how much was grit. Thus, I just left it alone. I think the surface skin just closed over those nasty bits. Now, they want out.

At the advice of the ER doc, I have kept the wounds covered in an antibiotic ointment. That's interesting about the allergic stuff. I am very fair and sensitive skinned. It takes nothing for me to break out.

And, I can certainly believe those bits taking a long time to get out. The sand is just so gritty and hurts like road rash injury all over again.

I've always thought you should really scrub the heck out of new road rash and get all the grit out. If you don't, you're prone to infection and scarring. When I was hit by a car (2002), the ER scrubbed and scrubbed and scrubbed (but was nice enough to numb me first). They missed one little tiny spot on my shoulder and I can still see the nasty little piece of grit in there under my skin.

I'm a big proponent of wet wound healing for road rash. Keep the wounds wet and covered (tegaderm, saran wrap, etc) and scrub them every day. Do not let scabs form. Your skin will heal from the inside out and your chance of scarring is minimized. Typically, you'll see pretty, new, fresh, pink skin in about 10 days.

Since it's been so long since your crash, I would ask your doc for advice.

Lorri

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Originally Posted by Catriona

My friend that's a nurse in a Denver trauma center says that they use spray and wash to clean up road rash at work - for motorcycle or bike riders. She says it's the gentlest & best method they've found.

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Spray & Wash, the laundry stuff? I want to know more about this!

Quote:

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Originally Posted by staceysue

Spray & Wash, the laundry stuff? I want to know more about this!

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Yeah. the laundry stuff.

http://forums.goingprepared.com/view...ay+wash#p13269

Scroll down to Ski Nurse's comment for the original, I'll just copy it here:


The BEST thing to clean road rash with the least amount of sting????

Spray & Wash.

Yep, that is what we use at the hospital. It works fabulous with a lot less scrubbing. And when you have to clean somone that hit the back of a car on their motorcycle @ 70mph & thes flew 120 feet without a helmet (oh, it was on the back of his bike) and has road rash literally from the top of his forehead to his toes, you want the easiest & less painful way.

Buy it....Spray & Wash.

Yep, the one that comes in the green bottle. Weird. But I promise you that it works. When we use it on our patients that are actually awake and/or coherent, they experience a lot less discomfort than when we are scrubbing w/ soap and water.

Now, I haven't actually used it on myself, but I would.

And people think that critical care medicine is complicated!

Also, reading the one "obra" article. Yes, try to keep the road rash from scabbing, but it eventually will. After we do the scrubbing, then we just apply bacitracin (helps with the scarring too) all over. We actually don't put on ANY dressing (tegaderm, telfa (like just the non-stick portion of the bandaid) unless there is a significant amount of drainage. Tegaderm WILL collect the fluid underneath.. It isn't as permeable as people think..it's a bit more occlusive, and that is just gross to have that fluid sitting there under the dressing. Ewww. A non-stick dressing like telfa is good if the road rash is, say, on you leg and you want to wear pants...then it will keep the road rash from sticking to your pants OR the drainage from getting on your pants. If the road rash is really weepy, we use a dressing called "Mepilex". It is an amazing product that pulls the yucky moisture out, but it maintains a moist, wound environment. I don't know if it is availble over hte counter at this time. Maybe I just have to add this to my first aid kit!

In a nutshell, if you can, clean the road rash really well of all debris, dry and then apply an ointment like bacitracin...you don't need an antibiotic ointment (neosporin). They can actually cause more harm than good. Keep the areas open to air as possible without applying a dressing.

I can't actually help here, luckily, I've no experience on either side of a nasty road rash, but before anyone starts spraying anything on Miranda's road rash, are there any special considerations for that she's asking about cleaning out road debris that is lodged in her FACE?

I can understand the ER staff not doing much poking around there, but don't they usually call in plastic surgeon types when there are significant facial wounds?

Miranda, I don't know where you live, but I know there's a "wound care center" here in Boise -- maybe check for one of those to help with this mess?

Karen in Boise

Quote:

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Originally Posted by Catriona

apply an ointment like bacitracin...you don't need an antibiotic ointment (neosporin). They can actually cause more harm than good.

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:confused: Isn't bacitracin an antibiotic that's one of the three components of triple antibiotic ointments like Neosporin?

Back in my racing days we used to always use Second Skin on road rash. I still see it for sale in the LBS's. At the drugstore, it's with the burn dressings. It's an aqueous polymer gel on a membrane similar to Tegaderm. The gel both keeps the wound from drying out/scabbing over, and also absorbs any fluids that seep from the wound.

But it sounds like Miranda has a different problem... for which I don't have any advice, only my wishes that it heals quickly and completely. Shame on the ER for leaving you to debride it yourself. That's more than I would've had the nerve for, either.

You hear it a lot with MC wrecks and I suppose it's the same with adult bicyclists. Many ER staff blame you for your injuries, believe and even say that you deserved what you got, and give minimal, or even no, pain relief or attention to injuries that may be disfiguring but not disabling.

At AE for my face road rash, the nurse put on antibiotic eye ointment- much gentler on the skin. Worked a treat- no scars!

Checking back in on my thread here... thx:) for posting those additional thoughts.

My face was moist for about 2 weeks with the ointment before the breakout bumps started to form on some of the new pink skin. Since then I stopped it. Did get a bit crusty. But, I am hoping it won't turn out bad. My eye check bone area it still itchy / crunchy. I think I got some of the sand dug out on my own.

This was my first time with major road rash like this. If lord forbid I have a "next time" like this, the numbing pain shot & scrub everything out on day of crash is what I will be asking for if I don't get it (like this time).

I am so fair skinned that it takes FOREVER for any tiny scratch to look normal again. Guess time will tell on this one.

I'm still scary looking to people in public. If asked, I immediately whip out my cell phone and show them the day 1 crash pic I took in the ER and say... "see it's looking better than it did, check THIS out...".

Lordy... one of the workers at my fav coffee shop said "wow... that does not even look REAL!". Well, yea... it is for real... I can vouch for it--been living it.

Just reading this thread, makes me truly not want to fall bad and scrape.. :eek:

Really hope Miranda your face heals well and smooth.

I had a crash in Feb but don't remember this particular problem. My wounds were washed and stitched up before my concussive amnesia wore off though but the road rash burned like hell for awhile. They were keeping it moist with antibiotic ointment and they put a maxi pad on with tape over it as it doesn't pull at the wound like a band aid. Kind of weird, but I guess it worked.

Keep it moist. Keep antibiotic ointment on it.

Also sadly sometimes the chemicals in the road cause the skin to hyperpigment which will cause some color to your scar. This happened to my leg but not really to my face. Put a lot of sunscreen on it when it heals to avoid hyperpigmentation, however it may be unavoidable.

Wish you luck.

Did you say you hurt your shoulder. I did too. Broke my scapula really still a pain but I'm starting formal therapy next week.

I would probably just go to someone like a PCP and ask them to debride it hopefully they can inject it with some local anesthetic. Better there than a wound center which is for complex non healing wounds usually.