Treat Road Rash

Have you taken a header off of your bike, skateboard or inline skates and sanded off a big patch of the largest organ of the Integumentary System (the epidermis)? Here is how to care for your recently exposed nerve endings.

Steps

 * 1) Stabilize Life Threatening Injuries. If you have severe bleeding or spurting blood, apply direct pressure immediately and call for help.
 * 2) *How to Stop Bleeding
 * 3) *Call or direct someone nearby to call your local emergency number.
 * 4) *If a head injury has occurred, check for a concussion.
 * 5) Assess the severity of the wound, call the emergency number in your area if you:
 * Can see underlying structures through the abraded skin.
 * Have skin hanging from the wound that needs trimming.
 * Have cuts that need stitching.
 * 1) Determine if you have other injuries. If you were knocked out or feel confused, or if you have limited range of motion in any joints, consider seeing a doctor immediately for medical assistance.
 * 2) Allow minor and self-limiting bleeding. This will help clean out any embedded dirt from the deeper portions of the wound.
 * 3) Wash the injured area gently but thoroughly with soap and warm water. This will hurt, but it's important to get all of the dirt and debris out of the wound.
 * 4) *Do not apply antiseptics such as hydrogen peroxide, iodine or bactine to the wound, as these may cause damage to exposed tissues and slow healing.
 * 5) *If available, irrigate the area with a mild solution such as .9 sodium chloride (easily available in drugstores as "saline solution")
 * 6) Apply an antibiotic ointment, such as Bacitracin or A&D ointment. In addition to preventing infection, this will help prevent the scab from becoming rigid and cracking when you move.
 * 7)  Cover the area with a loose non-stick dressing to prevent foreign matter from entering the wound. This will also prevent the wound from oozing onto your clothing and bedding. Change the dressing frequently to prevent it from adhering to the wound.
 * 8)  Gently wash the area at least once a day with soap and water.
 * 9)  Switch from a gauze dressing to a moisture barrier covering such as a Tegaderm dressing by 3M or Adaptic by Johnson & Johnson, a few days after the injury.
 * 10) Stop applying a dressing after the wound stops oozing, usually 7-14 days after the injury for a moderate case of road rash.

Tips

 * Remember, prevention is the best method of treating road rash. Wearing proper protective clothing and a helmet will greatly increase the chances of you just brushing yourself off and bouncing back up.
 * Cuts that are deep and have edges that pull apart may require stitches.
 * Applying a cold pack to the site of the wound will help relieve pain. The cold pack should be applied on top of a loose dressing, not directly to the wound. This is especially helpful in the first day or two after the injury, when there is a lot of inflammation.
 * If you have a minor adhesive allergy, hold your non-stick dressing in place with breathable paper tape. When changing the dressing, apply the new dressing at a slightly different angle, so the tape is in different locations each time. This will help prevent it from irritating the same patch of skin repeatedly.
 * If you have a severe allergy to adhesive tape, use rolled gauze or a specially designed mesh sleeve to hold your non-stick dressing in place.
 * The elastic part of a (washed) sock works great for holding bandages on parts of your body (hands, elbows, knees) that bend and cause them to fall off.

Warnings

 * Road rash is also known as road burn for a reason. Deep injuries which cover a large surface area (like you might get from crashing a motorcycle, or a bicycle at racing speeds) are often best treated as a burn injury. Seek professional medical assistance if your injury covers a large area of skin.
 * If your injury has deep gouges where there is white material visible at the bottom of the wound, seek professional medical attention immediately.
 * If your wound becomes infected, seek professional medical attention.
 * Road rash can leave large scars. If you have road rash on your face or other cosmetically sensitive areas, seek professional medical advice.
 * Emergency physicians and paramedics look for possible underlying injuries before attending to the obvious wounds, such as road rash. Abrasions will not kill or cripple you, but the underlying broken bone, internal bleeding, or head injury might.  When the occurrence sounds bad (fell from the roof, hit by a car, etc.), even though things look okay at first, it's best to be evaluated and observed in an emergency department.
 * If you have not had a tetanus shot within 10 years (some say within 5 years for dirty wounds) get one. Though uncommon, a tetanus infection ("lockjaw") can be fatal, but is easily preventable by vaccine. See a healthcare provider (in the USA a nurse, or a Licensed Pharmacist may give tetanus shots without a doctor's prescription).
 * Cover your wounds, because healing skin injuries will tend to darken with excess sun exposure, or at least use a good sunblock when outdoors for several months to minimize "post-inflammatory hyperpigmentation."
 * Some triple-antibiotics, such as Neosporin, contain neomycin, which can cause contact skin allergies. If you notice a red, itchy, sometimes blistering rash in the shape of the bandage, you are probably allergic to the antibiotic ointment.  Switch to polysporin or bacitracin or avoid Neosporin to start.

Related Tips and Steps

 * How to Care for Superficial Wounds
 * How to Treat a Burn
 * How to Minimize and Treat Scars
 * How to Treat Swelling

Sources and Citations

 * Detailed Road Rash treatment tips (PDF file)