Er…

That is a fairly lightweight injury. You are a big jessie.

McHmish – here you are – not for the sqeamish

AdamW – Member
So, epo-holic, I have your written application for ‘being a puff’ in front of me and as an ambassador of puffdom I need to know what type of ‘puff’ you are, so we can see if you qualify for being fabulous.

Are you a cheesy puff, a salt and vinegar puff or a more exotic variety such as prawn cocktail?

Please note that currently there is a backlog of entries to being a puff, we’re pretty picky on it. It may help if you own Calvin Klein undies, at least one bottle of Lacoste and either pink lycra, SPDs or a boat that can be towed by a 4×4.

Posted 6 hours ago # Report-Post

Thats go to be one of the best return posts ever, well done that puff.

If I was a puff, I’d like to be AdamW because he’s cool as ****.

you get more skin loss than that at one of these 😆

you sir, are a big girlies blouse of such magnitude that I have run out of possible adjectives to describe its massiveness

Assuming it is more painful than it looks!

Shave your legs – no ingrowing hairs next time.
And spray on atiseptic!

TJ. I don’t often get wound up by you, but rather than posting smug comments about ‘correct dressings’ etc. maybe you could do the OP a favor by offering advice about treatment since it’s well known on here that you’re a nurse.

In fact, an article on the subject might well be a useful addition to this site as my on-line research on the subject has had me going around in circles with some sources saying to keep the injury covered, some sources saying to leave it open, some sources saying to use hydro-colloid dressings, others to use dry absorbent dressings and one and on. In fact, even the NHS seems unable to agree on what course of treatment is best as my recent road rash had two nurses arguing with each other over how best to treat it. The more senior of the two eventually answering my question of ‘Whats the best way to treat it?’ with the immaculately fence-siting answer of ‘it depends’. She declined to comment on what it depends on.

So, TJ, or any other health professional on here. What is the best way to treat road rash? Are there variable factors which affect the treatment? What are warning signs to watch out for that something may be wrong? What’s the horrible yucky gunky fluid that leaks out of road rash? How do you stop it sticking to your sheets whilst you’re asleep? If the rash is on a ‘bendy bit’ of your body, i.e. knee or elbow, whats the best way to dress it? How should one remove a dressing? Just yank it off and scream? Sit in a hot bath? Soak the dressing in a shower? What are the ‘right’ dressings to use? Does the type of dressing you use have to change as the injury heals? How often should dressings be changed? At what stage should the injury be left open? How long should road rash take to heal? Is there a variance in healing times due to severity/depth of injury, age of casualty etc? Is pain relief a good idea? How does one decide which pain relief to take? At what stage does one decide to go see a medical professional? Should the injury be checked by a medical professional? At the point of injury? Daily afterwards? Less regularly?

I look forward to your responses.

Keep it clean obviously, so best to cover it witha tubi grip type bandage when in bed,

Pop down to the local drop in centre for new bandages etc

if it goes red around the outside and the redness spreads straight to GP,

If it goes green and is oozing its usually infected, mine was and took about 12 days new dressings and anti biotic powder every day, alsong with a clean with water,done by a nurse, (i worked in a hospital last time i did it)

Also remember all these new dressings are promoted by the drug companies, so its in their intrests to push the latest product, salt water worked for me , and for hundreds of years before me.

Good grief….

What is the best way to treat road rash? Are there variable factors which affect the treatment? What are warning signs to watch out for that something may be wrong? What’s the horrible yucky gunky fluid that leaks out of road rash? How do you stop it sticking to your sheets whilst you’re asleep? If the rash is on a ‘bendy bit’ of your body, i.e. knee or elbow, whats the best way to dress it? How should one remove a dressing? Just yank it off and scream? Sit in a hot bath? Soak the dressing in a shower? What are the ‘right’ dressings to use? Does the type of dressing you use have to change as the injury heals? How often should dressings be changed? At what stage should the injury be left open? How long should road rash take to heal? Is there a variance in healing times due to severity/depth of injury, age of casualty etc? Is pain relief a good idea? How does one decide which pain relief to take? At what stage does one decide to go see a medical professional? Should the injury be checked by a medical professional? At the point of injury? Daily afterwards? Less regularly?

I look forward to your responses.

Get hysterical much? It’s a graze, not major surgery.

If you did nothing at all with it, it would get better all by itself. You can help things along by cleaning all the bits of road out of it and using something to keep it moist while it heals. If you want to use fancy stuff you can opt for hydrocolloid style dressings, if it’s a massive area you can even use clingfilm.

Should the injury be checked by a medical professional? Only if you want them to be really cynical with you.

Is there a variance in healing times due to severity/depth of injury, age of casualty etc? Well, yes….

for roadie in a strop: 😉
http://www.singletrackworld.com/forum/topic/wound-healing-gravel-rash-specifically-to-cover-or-not

If you’re treating yourself, the ?rst step is the most important – clean the wound as thoroughly as possible. Do this by both ‘jetting’ the syringe/saline solution over the wound and using sterile wipes.

Once you’ve got rid of the visible muck, clean the wound generally using a mild antibacterial soap, a washcloth and lots of water. Then pat the wound dry.

Dr Steffen agrees: “In the vast majority of cases, it’s a myth that road rash needs to be scrubbed. Betadine and peroxide are too harsh; soap and water is suf?cient. Gels and sprays do little.

“There are rare cases where debris becomes embedded in the wound and thus needs more attention; this should be done in an emergency department with pain medication, the proper equipment and experience.”

Dressing the wound

If using a healing hydrocolloid dressing, apply it and leave in place until healing has occurred. It’ll drop off in a week or so to reveal new pink skin. You do not need to remove the dressing or reclean the wound.

If you’re using more traditional dressings, apply a thin coating of antibiotic ointment once the wound is clean, followed by a non-adhesive gauze pad and then hold that in place with a combination of micropore tape and Surgi?x tubular bandage. Then monitor the healing process, cleaning and re-dressing the wound daily.

Dr Steffen sums up: “There are three phases to road rash care. The ?rst is to be bandaged 24/7. Phase two is covered during the day and open-to-the-air at night. Third is unbandaged 24/7, dried up and scabbed over.”

Keep an eye out for spreading redness, swelling, an increase in pain, pus or foul smelling drainage. All of these are signs of infection and if they’re present, you should consult a doctor immediately.

Once the scab has come off, new pink epidermis will be revealed. This skin has not yet fully healed and over-exposure to sunlight can cause permanent pigment change. Protect it with sun block or clothing and apply a moisturiser. Also bear in mind that you and your road rash are individual, and what works for you might not work for a mate.

Roadie – the reason I did not recommend a dressing is that the OPs GP said it was infected hence my advice was to go to a nurse to get it seen then the correct dressings could be used. Personally I doubt it is infected but I am in no position to be sure from a glance at a pic so go to a nurse is surely the best advice.

I have given the general advice many times before but here goes in some detail

In general – hydro colloid dressings are what I recommend and use. However great caution is needed with infection hence the above advice.

Granuflex extra thin or duoderm thin are the brand names – similar stuff to compeed but comes in a variety of sizes up to big sheets. Films such as oposite or tegaderm are a good option as well

You put the dressing on and leave it for a week. if the wound is dirty then apply after a shower – pat dry and apply the dressing. it will collect foul smelling gunk under it but this is normal. after a week it should be healed. sometimes they produce so much gunk that the dressing comes off – tape it down or replace it if it does. The dressing is flexible and water proof and there are various ways of cutting and applying it for awkward and bendy areas.

Specific answers

So, TJ, or any other health professional on here. What is the best way to treat road rash?

hydrocolloid xdressing IMPO

Are there variable factors which affect the treatment?

different opinions in the main. Infection is the main other factor.

What are warning signs to watch out for that something may be wrong?

swelling ( as in the OP) heat, redness around it, getting a high temperature, any other signs of systemic illness

What’s the horrible yucky gunky fluid that leaks out of road rash?

mainly lymph and white blood cells IIRC

How do you stop it sticking to your sheets whilst you’re asleep?

by using the hydrocolloid dressing

If the rash is on a ‘bendy bit’ of your body, i.e. knee or elbow, whats the best way to dress it?

the hydrocolloid is bendy and trhere are ways of cutting and applying it as well as specifically shaped sheets – I’ll google for an application guide

How should one remove a dressing? Just yank it off and scream? Sit in a hot bath? Soak the dressing in a shower?

soak of an absorbent dressing – however film and hydrocolloid don’t stick the the would at all and what you do is stretch them and they come off – usually easily.

What are the ‘right’ dressings to use?

hydrocolloid or film for uninfected. Hydrocolloid is my faveorite

Does the type of dressing you use have to change as the injury heals?

no – hydrocolloid for a week to ten days and its healed – probably only one application needed but may need changed after a couple of days depending on gunk levels

How often should dressings be changed?

as little as possible

At what stage should the injury be left open?

when yo have a healed skin surface

How long should road rash take to heal? Is there a variance in healing times due to severity/depth of injury, age of casualty etc?

Yes but 7 – 10 days would be the norm

Is pain relief a good idea?

I find the dressings take away most of the pain

How does one decide which pain relief to take?

From the amount of pain 🙂

At what stage does one decide to go see a medical professional?

any signs of systemic illness local infection. heat / swelling / redness / high temperature / other signs of being unwell

Should the injury be checked by a medical professional? At the point of injury? Daily afterwards? Less regularly?

Nurse not doctor. as above if there are signs of infection or delayed healing.

Wound healing is very much a matter of opinion in the medical trade. However moist wound healing is generally accepted as best nowadays but there are a few differnt ways of acheiving this.

IMO Hydrocolloids and films are best. others like paraffin gauzes and honey tulles or similar. There are huge numbers of products on teh market but what I have typed above is my experience and opinion. Note that advice given over the internet is worth exactly what you pay for it! Any concerns then go to a professional

Project – whats your experience / source? Some things there I would strongly disagree with and are not so far as I know evidence based.

http://www.chemistdirect.co.uk/savlon-hydrocolloid-dressings_1_29688.html

TJ, They worked for me, a few times, Also we had a patient come in with a deep cut on his leg, he had covered the wound with his sock soaked in urine, the consultant in A AND E said he hadnt seen that since he was training but it appeared to work as fresh urine is pure.

Lol this has kicked off a bit……

I do appreciate the input and also the ribbing from you guys.

Have to admit it doesnt look much but what you dont see is the wound is very red and infected although it has mostly stopped seeping now. The main issue is my lower leg has ballooned in size and i cannot stand or put any weight on my right leg. My job requires me to be on foot 10 hours a day and generally running about like a blue arsed fly, so thats out at the mo…… Pretty pathetic really for a wee graze!

Doc prescribed a course of antibiotics for the infection and rest for the swelling, have to say the pain was unbelievable last night.

The missus googled road rash and there are heaps of conflicting advice, you read what to do then the next arricle tells you not to do what you’ve just done, at this point we gave in, so off work it is yipee!

Cheers guys

So, epo-holic, I have your written application for ‘being a puff’ in front of me and as an ambassador of puffdom I need to know what type of ‘puff’ you are, so we can see if you qualify for being fabulous.

Are you a cheesy puff, a salt and vinegar puff or a more exotic variety such as prawn cocktail?

Please note that currently there is a backlog of entries to being a puff, we’re pretty picky on it. It may help if you own Calvin Klein undies, at least one bottle of Lacoste and either pink lycra, SPDs or a boat that can be towed by a 4×4.

Oh Sweet Lord this is genius… 😆

There are rare cases where debris becomes embedded in the wound and thus needs more attention; this should be done in an emergency department with pain medication, the proper equipment and experience.

This happened to me.

A big old slide down a tarmac hill left melted polyprop shorts and t-shirt embedded in a 200x200mm area of hip/arse.I completely lost the top dermal layer apparently.

A good scrub down with some pink disinfectant and a healthy dose of topical lignacaine and adrenalin did the job, but it took longer for me to recover from the liberal use of lignacaine than the treatment. I had the shakes so bad I couldn’t keep water in a cup and was dry retching from nausea.

Happy days!

hydrocolloid xdressing

What’s that? Putting women’s dressings on men?

So, more questions. I’ve never washed wounds. Should I? They are usually scabbed up by the time I get home anyway.

And what about foreign objects stuck in there, like bits of gravel? Really necessary to remove them?

I got gravel rash on my shoulder a couple of years ago after a crash at the bottom of Mt. Seymour. Got infected and was *very* painful. Bearing in mind this was Vancouver and their methods may be a little different. Good old scrubbing with anti-bacterial soap and a nail brush. The bigger bits of grit were picked out with a pair of surgical scissors. Hurt like hell whilst it was being cleaned by it felt much better after and there was no need for anti-biotics or anything! Sorted.

washing it is a good idea but do not use soap or anything but water unless you are in a position like Science officer. Even then I would be cautious with the strong soaps and stuff. Scabbing delays healing – the hydrocolloid or film dressing will soften the scab that forms inan hour or two. and keep the would moist

Don’t forget to keep the fluids up to rehydrate after losing the serum from the wound.

I ended up with vaseline gauze on that one, because they had nothing big enough and it had to be overlapped. Plus every other day changes at the nurses for the first week.

Its not rocket science to treat wounds like this if you have some common sense and a little intelligence, but getting hold of BIG dressings for home use is a real PITA IME.

its the common alternative to the films / hydrocolloids. Oldfashioned IMO