Recently I came across a good article that reviewed updated self-treatment guidelines for road rash. Most of us are eager to get our wounds to the point of scabbing over because we associate that with good healing, but, for a variety of reasons, this is only adequate for the smallest of wounds. Helen Iams, MD, staff doctor for the Jelly Belly Pro cycling team has the following advice:
~Check for other injuries such as head injuries, gashes, injured joints. (Always have a cell phone handy for Emergency Activation)
~If bleeding from a gash won’t stop within 15 minutes of applying pressure evaluate for stitches
In the Field:
~Rinse or wipe the area with sterile or antiseptic products (she recommends Preparation H wipes.) Spraying with water bottles may help remove dirt, but may also deliver bacteria to the wound site.
Get the Grit Out:
~Blanket the area with 4×4 inch gauze pads saturated with Band-Aid antiseptic wash
~Allow to soak a few minutes until the nerve sensation is dulled by lidocaine (Avoid overusing the lidocaine, as it may produce irregular heartbeat.)
~Gently wipe the area with soap and water to remove all bits of dirt/rocks/etc.
~Use liquid Dawn or baby oil to remove road tar
~Avoid using alcohol or hydrogen peroxide since they damage skin cells and may prolong healing
Let the Healing Begin:
~Apply Bacitracin to keep the wound germ free and moist
~Cover with a dressing held on with tape to keep the area protected until oozing slows down
~After the oozing slows in a few days, cover the wound with a protective bandage (Tegaderm (3M) that will keep the wound protected while the new skin develops. Leave them on until they fall off (a week or so)
~Control pain in the injured area by using ice packs to cool the area.
~Use acetaminophen instead of ibuprofen for pain since ibuprofen can thin the blood and lead to bruising in the area
~Any and all concerns should lead you straight to your doctor for evaluation
MORE READING on this topic can be found in a very nice handout written by Arnie Baker, MD.