road rash treatment?

have indianna jones suck the poison out.

ok now for actual advice. when i played ball on turf and got a turfburn i would just pour several large gulps of hydrogen peroxide or alcohol (rubbing, the other kind costs too much) on it. i'd wait about 2 minutes, take my after-workout shower and just ignore it. worked like a champ.

btw if everyone and their dog disagrees with me on this then too bad seeing as how i typically feel like i'm much larger than bacteria and microbes and by sheer size i can defeat them in combat easily.

... if you want to get better faster and with less scarring, may I suggest you see a Burn Specialist or Plastic Surgeon. Those two fields know more about your kind of skin damage than ANY ER doctor, EMT or pretty much any doctor. All to often, Internist's or GP's simply underestimate the degree of seriousness that road rash can create.

If you decide not to see a burn specialist or a plastic surgeon (preferable with knowledge about burn injuries) then see this sight for help:

http://www.arniebakercycling.com/pubs/Free/Road%20Rash%20ABC.pdf

Also, try this... a 3M product called Tagaderm (or Bioclusive by JNJ). Great Stuff.

BTW, Deep bruising (that usually occurs a few days after the injury) can complicate things a bit. So, you may feel OK now... if you get a deep bruise things can get a bit more serious with swelling... I still suggest you see a burn specialist.

Also, some recommend using Solarcaine as a deading agent to help in the cleansing process.... however, be very careful using this product since it to can cause problems if usage is abused

As for keeping it covered... the answer is yes. Anti-biotic ointment will work but NOT near as well as Tagaderm or equivalent.. The leaking clear fluid is usually a sign of infection. Cleaning the wound is essential.

Get well... and I hope you take my suggestion about seeing a burn specialist serious - you will see tremendous improvement very quickly. You will be pleasantly surprised if proper treatment is given.

Good Luck and happy healing...


FWIW Joe Moya


Edited by Joe M 2005-09-26 10:50 PM

OK, with all due respect, here is an ER docs opinion. Make of it what you wish.

Turf burn can be painful, but usually heals well if infection is avoided. While you _could_ see a plastic surgeon or burn specialist, you probably don't need one. Keep in mind that yoru injury was caused at a running speed, not a cycling speed, and collision was with a soft surface as opposed to concrete.

The severity of road rash is dependent on the thickness of the injury. The majority are considred partial thickness abrasions meaning that the dermis, or deeper layer of skin is still intact. The dermis contains the hair follicles and oil secreting glands. These are actually pretty important in wound healing as you'll discover at the end of the post.

Without seeing it, it is of course impossible to say how deep it is, but the following advice shoudl help:


1) Most important is good initial cleansing, getting off any crud from the outside world with warm soapy water and enough scrubbing to get the crud off. A little bleeding is OK. Alcohol and peroxide are not necessary and are toxic to the exposed raw tissues, but will not hurt intact tissue. Removal of bacteria in the ER and in the OR is accomplished mechanically, not chemically.

2) Most infection results from bacteria on intact migrating skin INTO the newly exposed wound. Therefore you should wash the surrounding skin well also. You could use betadine/iodine/peroxide/alcohol on the surrounding skin, but do not get it into the fresh wound as it will delay healing and damage healthy cells on the inside.

3) It will heal fastest with less scarring if the wound surface is kept moist. This allows new skin cells to migrate into the area with less resistance. The new skin will grow in from the intact skin first, like little ameobas. Really. There are two good options for keeping it moist and covered.
a) Light covering of topical antibiotic ointment, followed by a non-stick (telfa) gauze, covered with as much regular cotton gauze as needed to absorb the oozing fluid througout the day (more about fluid in a bit). Keep the whole works in place with a tube gauze dressing if you can find one, or a section of nylon panty hose, or some gauze wrap, or just some tape. THis would be my initial choice while you still have a significant amount of drainage.
b) A tegaderm dressing like Joe mentioned. Drawbacks of this in the early stages are the large amount of fluid that will collect underneath. This isn't harmful, just kind of gross. Benefits are that you can put it on once and ignore it for a few days. The clear dressing lets you see the wound underneath and look for signs of infection.

4) Oozing of clear yellowish fluid is normal. Your skin is your waterproof covering. When it is disrupted, you leak. Perfectly normal. Thick white oozing stuff is NOT normal. With a turf burn, you usually will not get a thick pus-like discharge because the wound is "open" and drains continuously. The type of infection you usually see with a turf burn is called cellulitis, and is a red swelling in the otherwise healthy skin surrounding your injury.

5) Your wound should be gently washed with warm water and soap once to twice a day. The dressings shoudl be changed when soaked or crusted. Expect to use a lot of dressings for this.

6) Interesting fact about turf burns/road rash: The hair follicles are usually still intact and good healthy epidermal cells (skin cells) are living inside the hair follicles that are inside the area of the abrasion. your new skin grows from the good skin inward, so turf burns will heal with "islands" of skin....pretty cool, huh?

Go see a doctor if you get a fever, your skin turns red and inflammed in the area surrounding the turf burn or you get red streaks in the skin coming out of the injured area.

This will take a while to heal and they usually do pretty well without any scarring at all. Tube gauze dressing will be one of your best friends while this heals as you can apply dressings without using much tape at all.

I may be a slow runner, but you get all this good advice for free. Plus, I stayed in a holiday inn express 2 nights before my back surgery...

EDIT: I just read the arnie baker handout Joe linked above. Good advice, he seems to agree with me on just about every point.

Edited by AdventureBear 2005-09-27 3:15 AM

Yes, wierd hours. last night was 4pm to 2am. stayed till 3am, got home at 3:30 am, wired until about 5:30 AM, slept till noon.

Oozing...that's why I would use the nonstick gauze for the fir, st few days, either way it's labor intensive to change or drain the dressing frequently. The tegaderm should seal well initially, but you'll have to lift a corner to let it drain periodically.

Truthfully, tegaderm is my new best friend. I use it at work to cover abrasions on my hands from rock climbing/mountain biking accidents, so I don't innoculate myself with MRSA or some other unknown icky bug.

How convienient that you had tegaderm "leftover" from brain surgery! Who would have guessed???

when I had REALLY bad road rash, I was told not to swim for 1-2 weeks. Any bacteria can get in and infect it. But since yours only sounds like a 1st degree road rash then I would not swim for 2-3 days. Also if you want it to heal faster do this...Put the Tagaderm on the wound and in place a non-stick pad on it (dont know the name of it), next wrap it in gauze and tape it all around tight but not too tight. Then dont do anything to it for 3 days, and every 3 days repeat the process, but you cant re-dress the wound. I had 3rd degree road rash covering left shoulder from a crash at 34mph ant Junior Nationals,that I got on August 7th, and I was completely helaled by August 20t, then did a tri on the 21st.


Edited by gocorey 2005-09-27 11:39 PM

I would wait a few days till it stops draining so much. I also feel kinda guilty if it's still icky aout of consideration for others usign the pool.

Having said that, the kind of gentle debridement you can get from spending time in a warm shower or pool can be good to help get rid of dead and sloughing cells. Just be sure you wash off afterward and get it covered with ointment or tegaderm.