Roadrash!

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 chime in.

There's alot of bad and outdated info out there about caring for road rash.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 the wound.
• 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.

Some random, quickly-googled references: