Originally posted on August 25, 2011
If you’ve ridden a bike long enough, you’ve heard of road rash – that superficial abrasion of the epidermal layer of skin. It can be quite painful because nerve endings in the dermal layer are exposed when the upper layer of skin comes off.
How do you treat road rash? Wound care practices used to be to clean it with hydrogen peroxide and let it scab. Ouch! Besides being painful, it’s inefficient. The new skin has to tunnel underneath the scab, so the wound can only heal from the edges in.
The newer, preferred technique of wound care is to keep the wound moist and covered. Not only are the nerve cells covered, but also the scab can’t crack or stick to sheets or clothes and require healing to start all over again.
Keeping a wound moist decreases healing time by half. Faster healing occurs because the skin can migrate inward more easily and little islands of skin grow from the inside of the wound out, creating an efficient environment for healing.
Just clean the wound gently with plain water or saline and soap to remove all debris and cover the wound. For the first couple of days the wound tends to leak fluid and will require daily dressing changes. When a dressing is removed, gently cleanse the area with body temperature warm water, let it dry and re-dress. Usually after day 2, the dressing can stay in place for 3 to 7 days, or until the wound is healed.
The best dressing is one that does not stick to the abraded surface. For the first few days, use impregnated gauze or a telfa style dressing (nonstick gauze) held in place with a gauze roll or a stretchy gauze tube. Once the abrasion is less leaky, place a semi permeable dressing (such as Tegaderm) on the wound. The dressing should cover 1-2 inches beyond the margins of the injury. A semi permeable dressing is perfect because it is permeable to water vapor and oxygen but impermeable to water and bacteria. It also covers the exposed nerve endings, minimizing pain. This dressing should be changed only if it is no longer adhering or leaks fluid.
If money is not an issue, use a hydrocolloid dressing, such as Duoderm right away. This type of dressing is more absorptive and forms a gel like mass that keeps fluid in place. Hydrocolloid dressings also provide a thermal barrier that keeps wounds warm. Because warmth facilitates good blood flow, a warm wound heals more quickly. Every time a dressing is removed, exposure to cooler air delays healing.
Once the wound has a new pink layer of skin, it can be dressing free. New skin is fragile, so avoid sun exposure and excessive friction. Loose clothing is ideal, but if the area is exposed to sun, use very protective sunscreen, ideally containing zinc oxide.
Please call Margell Abel, MPT, ALTA’s own Wound Care Specialist, with further questions 303-444-8707 Ext. 110 or contact us at our email address, firstname.lastname@example.org.