Road rash - treating and minimizing scars

[Susie Derkins]

Last weekend I crashed pretty hard in the bike leg of a tri, and got some major road rash:

I also have it down my right leg.

I was taken off the course to the ER, since it was a pretty bad fall, and there was a lot of gravel in the wounds. Since then, I've been keeping it covered with dressings, covering it with triple antibiotic ointment, and changing dressings daily. Last night we tried Tegamet clear dressings on a few of the small ones, just because the huge bulk of the dressings was making me feel like an invalid. Tegamet works ok, but doesn't stay in a lot of spots (shoulders, knees, ankles, etc). So question 1 is, how do you usually treat road rash?

and 2, since a few of my really shallow ones are at this point, what do you do to keep scabs soft (I simply couldn't cover every single spot, so I have a few scabs), and to prevent scarring? Any suggestions are appreciated - having so much of it is brutal.

[ehirsch83]

Here is my tried and trued method(which was taught to me by my UCI license holding SO who has had more crashes then one should have,lol!)

in shower:
1)Anti-bacterial soap, scrub.
2) hydrogen peroxide

out of shower:
1)iodine solution
2)antibiotic cream
3) tegamet where it will stick
4) for places that tegamet does not stick- use anti stick gauze pads with the fishnet sleeve stuff over it(for arms and legs) or anti stick gauze pads to cover whole area and then the white adhesive tape around it.

repeat daily

it isn't fun but it does work.

Your road rash looks painful! I hope it all heals up and you feel better!

[Bethany1]

Oh my goodness. I can't help you, but I hope you heal up soon. Now I feel bad for whining about my scraped up knees to my DH the other day.

Sending (((HUGS))) your way.

[zoom-zoom]

Oh my goodness. I can't help you, but I hope you heal up soon. Now I feel bad for whining about my scraped up knees to my DH the other day.

Sending (((HUGS))) your way.

Yeah, no kidding. My knee owie pales in comparison. Susie, that looks incredibly painful! I hope you're able to sleep OK. So badass!!!

[Owlie]

That looks awful. With DBF's crash, the advice was to keep them moist to minimize scarring. I forget what he said they did, but it was similar to what was suggested.

Heal up quickly! Hopefully you can get to sleep...ouch...

[OakLeaf]

Ow ow ow.

I've been having really great results dressing wounds with raw honey covered with Tegaderm. You can tape down the edges if necessary.

Back in the day we used to use Second Skin - if the LBS doesn't have it, it's in the drugstore with burn dressings.

Rest, don't skimp on the pain meds, and heal. Pain is exhausting even if you're not really experiencing it as pain, and that'll tear down your immune system, making you extra susceptible to getting sick.

And keep it out of the sun for a year. (says the one who is still going around with a big glob of white sunblock on my upper lip every time I go out the door, and with big brown patches on my knees, shoulders and elbows from 20-year-old road rash that got sun on them)

Hope you heal up quick.

[westtexas]

Personally, I'd substitute betadine wash for the hydrogen peroxide, since H2O2 also destroys healthy cells. Again, betadine wash is available in generic form, and costs much less.

+1 on this. I have been trying to break my mother of the H2O2 habit for years because of this.

[Susie Derkins]

Thanks for the responses. I will have to look into the sleeve thingys (I know what you're talking about, just not what they're called) to keep the dressings in place on my arm and leg. The cream vs. the ointment sounds good too. The ointment is pretty gross, and once it spreads around, it keeps the tape from adhering well.

Today is day #4 since it happened, and dressing changes are starting to hurt less. Yesterday was the first day I did dressing changes w/o any pain meds. I would love to try a shower soon. How long would you wait? I'm afraid the water will sting something awful, and with so much open, that would be incredibly painful.

[OakLeaf]

Depends on your pain threshold I would think ... you could always try a shower and switch to a bath if it was too bad.

Honey isn't gross, because you really don't use enough to be sticky. Just a thin layer to coat the wound. (What is gross, is the way sweat builds up underneath Tegaderm. At least it mixes with honey, where it'll make a separate pool from petroleum ointments.)

I try to keep petroleum off wounds now, unless they're showing signs of infection. This winter I started out treating the gashes in my face with Neosporin and it really seemed to inhibit healing.

[Bethany1]

I have to ask, is the bike okay? That's the important thing right? LOL

[Rebekah H]

Dude, that is sexy. LOL I hope you're okay! When you're all healed up, go to your derm and ask for Obagi Clear. It's used to treat acne scarring and is fantastic. The Clear is a little on the pricey side, but so worth the money.

[Eden]

I recommend Duoderm or a similar dressing to anyone with road rash.

It is expensive and it is gross, but it really works and it helps cut down on the pain too because it protects well. You may however have trouble finding sheets large enough for patches as large as yours....

It is nasty - you put it on and leave it on until it falls off. It turns kind of whitish from its yellow/clear unused appearance and gets a bit puffy. (it is *not* puss - it is the dressing absorbing and holding moisture) It usually stays on for 3-7 days depending on how often you shower and how dry you can keep it when you do.

It heals up road rash about twice as fast as spots that are allowed to scab up.

[Susie Derkins]

I have to ask, is the bike okay? That's the important thing right? LOL

Amazingly - yes! Just found out last night. I need new bar tape (mine was white and I bled all over it), new shifter plates, new hoods, I ripped the (brand new - damnit!) saddle, and a couple other little things, but they are all cosmetic. The frame is sound, so she will ride again. Woot!

[redrhodie]

That looks so painful. (((Susie))) I hope it stops hurting soon!

[Abarnes]

Having raced for many years, I know all too well about this topic

a good link on road rash treatment from Dr. Arnie Baker: http://arniebakercycling.info/pubs/F...Rash%20ABC.pdf

The key to road rash is to make sure there is no debris in the wound, period. Yes this means de-briding - which I prefer to do myself, rather than the intern in the ER. They actually use a bristle brush.

Treat the wound like a burn in some ways - sliding on the pavement can really 'cook' the skin as well as slice it. Keep covered, keep moist. Change dressings every day, slough off dead cells (blood, skin) to reduce scarring.

I do not prefer the Tegaderm style of occlusive dressings primarily for the expense. Some of my various road rashes have been a bit on the "XL" side of surface area, so it would take 2-3 Tegaderms to cover my big a$$.

The guaze bandage/fishnet bandage combo work great over joints (knees and elbows)

The elastic 'fishnet' bandage can be found at CVS: http://www.cvs.com/CVSApp/catalog/sh...e_Free_Listing