Road Rash

They say there’s two types of cyclists in the world, ones who have come off their bikes and ones that are yet to. It is inevitable, or at least highly likely that if you spend enough time on two wheels you will eventually hit the pavement.

If/when the unforeseen happens it is helpful to know how to handle the situation, and when it’s necessary to leave it to the professionals.

The first time I crashed (yes it’s happened more than once) occurred when I hit a pothole riding around 30km/hr on a training camp. Fortunately no cars were involved and no bones was broken, but my self-confidence took a beating and I lost a considerable amount of skin off my arm, shoulder and knee. Lucky it happened on camp so the sag-wagon picked me up and took me home. Upon my arrival back into civilisation I went into my workplace (pharmacy) and my wounds were disinfected and bandaged up by my wonderful colleagues. But if you’re not so lucky to work in a pharmacy or hospital maybe keep this guide on hand in case you fall victim to some road rash.

Please note this is general road rash advice, obviously the first step after a bike accident would be to assess the general health and condition of the patient (not just the bike). Check for concussion, broken bones, impaired movement and coherence etc. if there is any doubt please seek urgent medical advice. If you are just missing some skin and want to know how to address that… Read on!

Firstly assess the wound, how deep is the abrasion, is there any laceration or need for stitches, has it stopped bleeding after compression, are there any foreign bodies in it. If there are deep cuts or it won’t stop bleeding see the Doc straight away.

Gravel, dirt and sand will need to be removed, either by flushing with saline solution/clean water, or gently removed with tweezers if pieces are embedded. Antiseptic solution should be used at this stage to wash the wound and reduce the likelihood of infection and inflammation that will delay wound healing.

For over one hundred years we have been told to dry out wounds, let them air/breath you know the story. But modern medicine recommends the opposite, evidence shows that moist wound healing is now the way to go. Providing your wound with a moist environment will speed up the healing, prevent scabbing and prevent scarring. But how do we implement such a thing? That’s where your friendly pharmacist comes in… There are a few dressing options available in Australia depending on the size and depth of the wound, and how much money you want to spend.

Solosite™ is a soothing and hydrating gel that can be applied onto minor grazes with or without a dressing over top. It rehydrates sloughy and necrotic tissue, promotes moist wound healing and can be reapplied frequently. A handy addition to your first aid kit, it can also be used on sunburn, cuts and scalds. In the case of road rash I would recommend applying it liberally on the first day of the wound occurring after thoroughly cleaning and disinfecting it, then applying a suitable sized dressing.

Some hospitals are now using Fixomul/Primapore directly onto shallow grazes and burns. It is a low allergy, self-adhesive lightweight dressing suitable for low exudate wounds. The tiny holes mean it’s not fully waterproof but you can wear it in the shower without a worry. As your skin regenerates the dead skin cells on top are what sticks to the adhesive, so you can leave it on until it comes off itself (usually a couple of days) or soak it in baby oil to remove earlier. At first people are hesitant to put adhesive directly onto an open wound but the sticky part won’t stick to moisture, so the wounds are actually able to heal in their own exudate. It is my personal favourite dressing, I use it myself and get a lot of positive feedback when I recommend it to customers. My only hesitation would be using it the first day after an accident if there’s a lot of exudate, in this case choose a dressing with an absorbent pad and apply Solosite™ as previously mentioned.

With each dressing change you should clean and inspect the wound for signs of improvement or infection. If the wound becomes infected you will need to see your doctor, infection can delay healing and potentially cause life-threatening illness. Signs of infection include redness, heat, inflammation, odour, increased exudate, increased tenderness or irregular tissue that bleeds easily. When in doubt, get it checked out!

Apart from the day/night of the accident when it is totally acceptable to eat any and every comfort food in site, whilst you are on the road to recovery try to eat healthy foods that promote healing. These include omega 3’s (salmon, flax seeds, walnuts), protein (lean meat, chicken, eggs, milk, yoghurt), vitamin C (citrus fruits, strawberries, tomatoes, cabbage), vitamin A (dark green leafy veges, fortified dairy products, yellow and orange veges) and zinc.

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