Forum: bicycles.stackexchange.com
Tags: <health><injury>
Title: What do you do to cure road rash more quickly after a crash?
Question: Crashes are an inevitability in cycling. This weekend, I hit a 4" stick on my bike. It flipped over, stuck in the spokes of my front wheel and did this to it:   It stopped my bike really quickly and I wound up flying over the handlebars, and earned a trip to the local ER where they spent an hour scrubbing the road out of my face, arms and shoulder.  So what tips and tricks do you folks have for recovering quickly (and without scarring) from road rash?

Answers:
sents: text: Wow!
text: That looks like a horrid crash.
text: There are some newer ideas on road rash healing.
text: My doctor recommended that I NOT use Neosporin type ointments.
text: The reason being that it only has an affect on the superficial layers of the wound and that infection, if it occurs, will be in the deeper layers; and also that topicals are shown to interfere with wound healing.
text: He also told me not to use hydrogen peroxide as it damages tissue.
text: The keys to healing and preventing scarring are to keep the wounds clean and moist.
text: The advice I got from my physician (who is a cyclist) is pretty much the same as the advice here on freewheel.com .
text: According to the article and my doc: After a proper cleaning it's recommended to apply an application of a hydrocolloid or semiocclusive hydrogel dressing.
text: "A moist healing environment is provided by the dressing...
text: Two basic options fulfill this requirement.
text: " Semipermeable film dressings , such as Bioclusive (Johnson & Johnson, New Brunswick, New Jersey) andTegaderm (3M Company, St Paul), in combination with semiocclusive hydrogels such as Spenco 2nd
text: Skin (Spenco Medical Corp, Waco, Texas).
text: These dressings are impermeable to water and bacteria but allow the exudate to evaporate." Hydrocolloidal dressings .
text: Examples of hydrocolloidal dressings are Duoderm (ConvaTec, SkiUman, New Jersey) and Cutinova hydro (Beiersdorf, Inc, Norwalk, Connecticut).
answer_details: author: bicycles.stackexchange.com/users/None/
score: 14
sents: text: One suggestion: Neosporin.
text: Every time you change a bandage, wash it out and slather that stuff on.
answer_details: author: bicycles.stackexchange.com/users/50/Jack M.
score: 9
sents: text: The main idea is to keep scabs from forming.
text: Scabbing retards the healing process greatly, and will increase scarring.
text: The Neosporin that was suggested above and other generic antibiotic ointments help with this; this is an economical solution.
text: You can get gauze that is already impregnated with Neosporin-like things, or you can apply the ointment to the wound and then put regular gauze on top.
text: For large areas, it can be hard to keep the bandage on the wound which is why I recommend other products like Tegaderm .
text: Tegaderm and similar products that are designed for burn victims work great.
text: The nice thing about tegaderm is that you can stick it on the rash (once it's clean) and then leave it on there.
text: It stays on the wound without needing tape or other adhesives, but it doesn't pull or damage the healing skin when/if you pull it off.
text: It forms a protective "skin-like" layer while the skin underneath grows back.
text: You can leave it on for a long time without changing, and it speeds the healing immensely.
answer_details: author: bicycles.stackexchange.com/users/288/kevins
score: 7
sents: text: First is getting the hair and dirt out of the wound, which it sounds like the ER has done for you.
text: In the first 24-48 hours, I've found the gel bandages to vastly improve the time it takes road rash to heal.
text: They seem to wick away a lot of the fluids which build up on a fresh wound.
text: I get something similar from playing goalkeeper on occasion.
text: I'm unsure of the exact science involved, but as the bandages never seem to be able to get 100% coverage, it is easy to see exactly which areas have the bandages and which don't.
text: The area under the bandage heals considerable faster and the scabbing comes out much smoother and flush with the skin.
answer_details: author: bicycles.stackexchange.com/users/389/LanceH
score: 6
sents: text: I have followed both @Jack
text: M. and @LanceH's advice before and both worked well.
text: I also followed that up with anti-scar cream for a nice face wound I had.
text: I think it helped, but I'm not that interested in doing a personal comparison study.
text: Search on amazon or head to your local drug store/chemist and ask someone there for a recommendation.
text: You use the anti-scar cream after the scab is off if I remember right.
text: And don't pick off the scab!
answer_details: author: bicycles.stackexchange.com/users/9/Mike Two
score: 2
sents: text: Bactine is an antibacterial with a pain relief formula of some sort in it.
text: I'll swear by it, as i got some rash longboarding a few weeks ago and after using it once or twice a day for a few days i don't even feel it anymore and it healing faster than normal.
answer_details: author: bicycles.stackexchange.com/users/5045/asdfghjkl
score: 2
sents: text: So many different way to heal, I'm noticing when I cover n
text: let nature take its course
text: I'm watching my facial burn heal more each day.
text: It is irritating having to tape up my face tho so I am off in search of duoderm or something that will allow my face to be free of sticky tape while avoiding scarring.
text: Definitely keep your wound covered.
text: My sister who is a dr without the degree swears I'm going to get infection by the bandages, but she is being proven wrong.
text: I have photographed the wound each day and see a noticeably different wound each day that passes.
text: I cannot wait til it's gone tho, but realize time is of the essence.
answer_details: author: bicycles.stackexchange.com/users/4133/Ginger
score: 1
sents: text: What I've found, after the first 24 hours or so when the wound is oozing, is that leaving it uncovered but coating it with ointment works best.
text: (Preferably use an antibiotic ointment, but plain old petrolatum is OK.)
text: If the wound is in a place where it might get bumped, or you consider it terribly unsightly (though how can a biking wound be other than a badge to wear proudly?)
text: then you can lightly cover with gauze.
text: The ointment holds in the moisture, which is what you need most to promote healing.
text: And antibiotic ointments have been shown to increase the speed of healing over non-antibiotic.
answer_details: author: bicycles.stackexchange.com/users/1584/Daniel R Hicks
score: 0
sents: text: Not really an answer in the long term, but excluding air from the wound helps.
text: So as a get-home fix you can use something like clean gladwrap / sarin wrap to cover the wound after washing out all the dirt.
text: Also stops the wound from stinging as you get home.
text: Using this method I have a 3" line on my forearm where there are now no freckles, but you can't feel it, and hair grows normally.
text: Plus you can see through the plastic and observe if you've missed any lumps of road.
answer_details: author: bicycles.stackexchange.com/users/19705/Criggie
score: 0

Summary of the answers:
After a crash, keep the wound, clean, moist and covered. A product such a Neosporin or other antibiotic cream can be used. Do not pick scabs. Tegaderm is an option for large areas that are hard to bandage.
There are conflicting views on the suitability of Neosporin type antibiotic ointments for road rashes, despite its popularity and widespread use. Treatment with hydrogen peroxide is also challenged. The use of bandages is also a point of debate, as some argue that large areas or fresh, oozing wounds should better be left uncovered and treated with ointments and dressings, preferably antibiotic. Others, advise using bandages and gel bandages in particular. At any rate, keeping wounds clean and moist is critical to avoid scarring, next to applying hydrocolloid or semi occlusive hydrogel dressings, using anti-scar cream and avoiding scabbing. Before treating the wound, it is important to clean it and remove any dirt or hair. You could use gladwrap or sarin wrap as a temporary solution. You could advise a health professional or find more information online.