The wacky misadventures of the SF->Google/south-bay bike commuter gang
Thursday, August 13, 2009
Hey everyone. Let's talk about road rash! Every one of us will crash
someday (sorry) so this is something we all need to know. I'm
including here the knowledge that I accumulated from 2.5 years of
racing and over a dozen crashes in that time. I don't claim to be an
expert and everyone has their own opinions on the subject so please do
There's alot of bad and outdated info out there about caring for road
rash. Most of the patch-up jobs I've gotten at races (and even in the
ER) have required 20-30 minutes of soaking and tugging and tears at
home to remove the crusted-on bandage and then redress properly. The
general gist of this method is 1) keep it moist and scab-free at all
times, and 2) let your body do its thing. You should be able to find
tegaderm and hydrocolloid bandages at at least one local supermarket
or drug store in your area but it might take some hunting.
Step 1: Crash (or if possible, don't crash and skip to step 9).
Step 2: Make sure you don't need to go to the ER. Do you have any deep
gashes that might need stitches? Do you see alot of white in your
wound? Do you know what day it is? These are all clues.
Step 3: Go home and shower. You need to clean out the dirt and debris
from the wound. Do so with mild soap and water (unless you happen do
have a cache of sterile saline solution lying around...). Don't scrub
too hard or you'll cause even more damage. Do *not* use hydrogen
peroxide (as one wise medic once told me, "use that stuff to clean the
blood out of your clothes and nothing else").
Step 4: Dry the wound. Air dry or use sterile gauze.
Step 5: Apply Tegaderm over the wound. Cover a half inch of healthy
skin on all sides. Tile several pieces if necessary.
Step 6: Wrap a protective layer of gauze around the wound and tape it
securely. This both pads it and absorbs the fluid that will fill up
and eventually leak out of the tegaderm. I use surgilast tubular
elastic bandage retainer (see link below) to make this dressing even
more secure. Not easy stuff to find though.
Step 7: Now let it heal. You'll need to change the outer gauze layer
every time you shower of course but the tegaderm will last for several
days untouched. The wound will produce an alarming amount of fluid.
This is good. It keeps the wound moist, helps you heal more easily,
and the bubble under the tegaderm will help pad the wound even more.
Watch for infection. Burning sensations and redness spreading from the
wound are bad. When you change the Tegaderm don't scrub the wound.
That's new skin you'd be scraping away.
Step 8: After a few days or whenever the wound will stop weeping so
much switch to a gel/hydrocolloid dressing. These adhere to the skin
like tegaderm but absorb rather than collect the fluid that the wound
exudes. They're less tricky to apply and don't need a second gauze
dressing but they can't handle as much exudate. The dressing thickens
and turns white as it absorbs fluid and creates a sort of pillow over
Step 9: The wound is healed when the gel bandage stops pillowing up.
Treat the new skin gently.
For Trinh: I'd take a nice long bath or shower to soften your scabs a
bit before you dress your wound. Either tegaderm or gel dressings are
probably appropriate at this point. After a day or two under a moist
dressing the scabs will probably fall off on their own when you shower
and change the dressing.
For small bits of road rash that you may find next to your big missing
patches of skin, I still use antibiotic ointment and bandaids. Or just
small gel bandages.