Healing up Road Rash

[ldamelio]

Weighing in here as a senior trauma surgeon and someone who has laid the bike down a few times in Cat IV festivities. All of the above solutions work without much difference except how much $$$$ you put into Johnson and Johnson's pocket for stuff like Tegaderm, etc. Why ? Because mother nature is smarter than all of us and the body will heal best if you don't eff with her. A healthy cyclist will heal a wound like that with little intervention other than keeping it clean. On a practical basis, it's good to keep it covered because 1) it's a mess and 2) as others have pointed out, dry scabs around the knee restrict mobility and impair pedaling. I have no problems letting road rash away from the knee just scab over - mother nature's dressing. Mankind survived many millennia without Tegaderm. Antibiotics, counterintuitively, make no difference. Don't shave now, as that statistically is slightly more likely to cause infection. I just rinse twice a day (regular shower fine), pat dry with clean towel, then Vaseline and a dressing sponge and netting dressing. Many ways to skin this cat, pun not intended. Get back on the bike and enjoy.

[AJPM44]

Weighing in here as a senior trauma surgeon and someone who has laid the bike down a few times in Cat IV festivities. All of the above solutions work without much difference except how much $$$$ you put into Johnson and Johnson's pocket for stuff like Tegaderm, etc. Why ? Because mother nature is smarter than all of us and the body will heal best if you don't eff with her. A healthy cyclist will heal a wound like that with little intervention other than keeping it clean. On a practical basis, it's good to keep it covered because 1) it's a mess and 2) as others have pointed out, dry scabs around the knee restrict mobility and impair pedaling. I have no problems letting road rash away from the knee just scab over - mother nature's dressing. Mankind survived many millennia without Tegaderm. Antibiotics, counterintuitively, make no difference. Don't shave now, as that statistically is slightly more likely to cause infection. I just rinse twice a day (regular shower fine), pat dry with clean towel, then Vaseline and a dressing sponge and netting dressing. Many ways to skin this cat, pun not intended. Get back on the bike and enjoy.

Can this be made into a sticky?

[SteveP]

Weighing in here as a senior trauma surgeon and someone who has laid the bike down a few times in Cat IV festivities. All of the above solutions work without much difference except how much $$$$ you put into Johnson and Johnson's pocket for stuff like Tegaderm, etc. Why ? Because mother nature is smarter than all of us and the body will heal best if you don't eff with her. A healthy cyclist will heal a wound like that with little intervention other than keeping it clean. On a practical basis, it's good to keep it covered because 1) it's a mess and 2) as others have pointed out, dry scabs around the knee restrict mobility and impair pedaling. I have no problems letting road rash away from the knee just scab over - mother nature's dressing. Mankind survived many millennia without Tegaderm. Antibiotics, counterintuitively, make no difference. Don't shave now, as that statistically is slightly more likely to cause infection. I just rinse twice a day (regular shower fine), pat dry with clean towel, then Vaseline and a dressing sponge and netting dressing. Many ways to skin this cat, pun not intended. Get back on the bike and enjoy.

plz, no real expertise. this is the net...
i thk you should sandpaper the thing twice a day.. and pour whiskey on it and then drink some afterward.
always worked for me even though it takes 6 months to stop bleeding.
wade patten

[dgaddis]

Here's a tip: don't use New Skin. I have a spot about the size of a quarter on my wrist, right where the hand rest when typing or using a mouse, which I do all day long at work. New Skin is a clear protective, breathable, flexible coating. Seemed like a good option for the wrist, keep it from getting goo all over everything and be a lot more mobile than a bandage wrap. I bought a little spray can and tried it.

It hurts 1,000 more than the crash did! It BURNS, feels like napalm. And it didn't even work, I still had stuff coming through it and it just made it look worse. Know how you get it off? Spray more on and then wipe off before it dries.

It's basically clear fingernail polish in an aerosol can. After the burning stopped I looked at the can closer...the main ingredient is acetone.

[quickag]

Weighing in here as a senior trauma surgeon and someone who has laid the bike down a few times in Cat IV festivities. All of the above solutions work without much difference except how much $$$$ you put into Johnson and Johnson's pocket for stuff like Tegaderm, etc. Why ? Because mother nature is smarter than all of us and the body will heal best if you don't eff with her. A healthy cyclist will heal a wound like that with little intervention other than keeping it clean. On a practical basis, it's good to keep it covered because 1) it's a mess and 2) as others have pointed out, dry scabs around the knee restrict mobility and impair pedaling. I have no problems letting road rash away from the knee just scab over - mother nature's dressing. Mankind survived many millennia without Tegaderm. Antibiotics, counterintuitively, make no difference. Don't shave now, as that statistically is slightly more likely to cause infection. I just rinse twice a day (regular shower fine), pat dry with clean towel, then Vaseline and a dressing sponge and netting dressing. Many ways to skin this cat, pun not intended. Get back on the bike and enjoy.

So just pour Tussin (tm) on it?

[Octave]

Weighing in here as a senior trauma surgeon and someone who has laid the bike down a few times in Cat IV festivities. All of the above solutions work without much difference except how much $$$$ you put into Johnson and Johnson's pocket for stuff like Tegaderm, etc. Why ? Because mother nature is smarter than all of us and the body will heal best if you don't eff with her. A healthy cyclist will heal a wound like that with little intervention other than keeping it clean. On a practical basis, it's good to keep it covered because 1) it's a mess and 2) as others have pointed out, dry scabs around the knee restrict mobility and impair pedaling. I have no problems letting road rash away from the knee just scab over - mother nature's dressing. Mankind survived many millennia without Tegaderm. Antibiotics, counterintuitively, make no difference. Don't shave now, as that statistically is slightly more likely to cause infection. I just rinse twice a day (regular shower fine), pat dry with clean towel, then Vaseline and a dressing sponge and netting dressing. Many ways to skin this cat, pun not intended. Get back on the bike and enjoy.

+1

I spent a few years working as a paramedic, and dealt with plenty of these situations - both on others and on myself. In fact, I was crashed out of a race this weekend and lost about 16 square inches of skin on my ass and hip. I've gotten nearly identical healing-times with the expensive route (tegaderm et al) and the natural route (clean, antibiotic, dressing, suffer through it).

One piece of advice I can add from my recent experience is the use of ChomperBody's "Crash - Road Rash Recovery" - essentially a blend of oils, vitamins and herbs; smells and feels nice and seems to enhance the speed of skin-formation. Nothing extraordinary, but nicer than vaseline and not too pricey. Smells nice, too.

[pdxmech13]

A good all around guy who happens to be a monster on a bike and a doc prescribed me this the last time I had bad infection on a road rash wound. Works amazing and is only $20 perscription for 300g.

Silver sulfadiazine - Wikipedia, the free encyclopedia

Nick

[C.Dyer]

As an RN who does a lot of wound care, I'd absolutely endorse what Idamelio is saying here.

I'd also point out that when he says not to use antibiotics, he's not talking about pills. He's referring to Neosporin/Triple Antibiotic Ointment/etc. that have been mentioned regularly throughout the thread. That stuff just isn't indicated if you're keeping the wound clean.

[962]

The handlebar looks worse than your leg!

I did a slow slide after front washed out in a muddy hairpin on pavement...caught me by surprise like you said...

Also slid into a base at a softball game wearing shorts once. Not doing that again.

[guyintense]

Scrub the area really well with soap and water, let air dry. In a couple of days after you have a nice dry scab peel it off and you'll see all the rocks and shit you missed.

[j44ke]

Wait a minute - isn't being a doctor or an RN on this forum cheating? Sort of like factual information doping. Suddenly the bottle of leaches I bought in Chinatown doesn't seem so rational.

[ldamelio]

Nah - my post was based as much on common sense and experience as much as formal education. Half of practicing medicine well is ignoring hype, drug company-funded studies and marketing, cultural biases of allopathic medicine, etc. and just realizing that a healthy body heals many things very well on its own. The hard part is balancing the valid science versus the background noise and practicing with the right balance of technology/knowledge and common sense/experience. Can't be a Luddite, but also can't be an unquestioning fanboy of the "latest/greatest" output of medical corporate America. Constantly sorting it all out. Anyway, sorry for the thread drift. BTW, leeches still used in certain circumstances - they secrete hirudin, an anticoagulant. Uncommon, but sometimes plastic surgeons place them on/near flap reconstructions to secrete this drug locally when the patient can't receive systemic blood thinners. Sorry for the further thread drift - way too much coffee way too early. I'll stop now. And drink more coffee.

[defspace]

I crashed earlier in the week, so this has been an informative thread.
Everything has been as expected, but I found a swollen lymph node in my groin today - on the side that I slid on. This is the first time I've noticed it - four days out. Presumably that means my road rash is infected? I've been keeping it tegaderm'd and everything still looks and feels totally groovy. What's the appropriate course of action if you suspect infection?

[dgaddis]

I crashed earlier in the week, so this has been an informative thread.
Everything has been as expected, but I found a swollen lymph node in my groin today - on the side that I slid on. This is the first time I've noticed it - four days out. Presumably that means my road rash is infected? I've been keeping it tegaderm'd and everything still looks and feels totally groovy. What's the appropriate course of action if you suspect infection?

Amputation. DIY is the cheapest route.

No, but seriously, interested to see what folks recommend.

I'm scabed up and good to go now, have been since Weds. My bike is at the shop for a hanger realignment however.

Why anyone builds frames with non-replaceable hangers is beyond me.

[rabo]

The ER doctor (who scrubbed my wounds once way more than I cared for) also stated not to use topical AB. I think the reason was "if it's gonna be infected it will do that anyway by now, and the AB might not be effective later " (if we use them now).
He prescribed a big pot of silvadene I used with tegaderm that indeed is expensive. MD would only give me 10 vicodin, that worked incredibly well for the pain fpr ~4 hours.
One of my teachers used to say "we can not improve the bodies healing mechanisms , but we can optimalize the conditions that promote healing" (or something like that). Sounds reasonable. An argument that can be applied to the massage thread as well.

[Too Tall]

Good reading guys, appreciate input from folks in the medical arts too.
Guys, I've always ascribed to the "stop the scab from forming and keep it clean" school, that's worked for me many time as I'd care to mention. There are two ways I know that work for me to get there. First is vaseline or triple ointment, if you keep it goo'd up between cleanings no scab and when you do clean the scab is very poorly formed so it washes off better. Second is the classic wet/wet wound care that was taught to me by a plastic surgeon. Look here for details: Wet to dry dressing changes: MedlinePlus Medical Encyclopedia it involves keeping it clean, no ointments and covering with a wet surgical pad. This last method grows skin the fastest but is also most labor intensive. Using vaseline etc. is easier to deal with less labor intensive for a working man. Care to comment?

We should wiki this yes?

[Matthew Strongin]

We should wiki this yes?

No input other than to say, yes. Wiki worthy.

[dgaddis]

We should wiki this yes?

I was kinda hoping the thread would go that way when I started it.

[ldamelio]

To the poster with the swollen lymph node - if you have any redness, foul drainage, etc around the road rash then get some medical attention - you will likely need systemic antibiotics. If it looks and feels OK, don't sweat it - enlarged node can be normal action as these are the body's 'filters' and the enlargement likely reflects it doing it's job. On the odd chance it's still there a month after the road rash is healed up, get it checked out.

[devlin]

Nah - my post was based as much on common sense and experience as much as formal education. Half of practicing medicine well is ignoring hype, drug company-funded studies and marketing, cultural biases of allopathic medicine, etc. and just realizing that a healthy body heals many things very well on its own. The hard part is balancing the valid science versus the background noise and practicing with the right balance of technology/knowledge and common sense/experience. Can't be a Luddite, but also can't be an unquestioning fanboy of the "latest/greatest" output of medical corporate America. Constantly sorting it all out. Anyway, sorry for the thread drift. BTW, leeches still used in certain circumstances - they secrete hirudin, an anticoagulant. Uncommon, but sometimes plastic surgeons place them on/near flap reconstructions to secrete this drug locally when the patient can't receive systemic blood thinners. Sorry for the further thread drift - way too much coffee way too early. I'll stop now. And drink more coffee.

That has so many parallels with the bike industry it's not funny. Swap the leeches out with steel just to finish of the effect.