Banged up…best practices?

[guyintense]

Hydrogen peroxide kills normal cells within the wound — including healthy skin cells and immune cells — and slows blood vessel formation.

[thwart]

I had an amazingly similar minor crash 2 yrs ago; reaching back to turn on my back light on a foggy AM ride, hit a deep (but not visible until you’re almost on top of it) water valve indentation in the pavement with only one hand on the bars, and before you know it… I’m down. Luckily moving along at only 10-12 mph.

A difference was I suffered some deeper chainring gouges in my right ankle area, but no hip pointer as you’ve experienced.

Icing is useful for at least the first 24 hrs. No heat application during the initial couple of days.

You’ve got relative anesthesia for skin wounds for 15 min or so, so vigorous spraying and gentle scrubbing with water from your bottle (if you’re close to home, it’s obviously better with more water) immediately after you get up, dust yourself off and utter a few choice words is a very good idea. See a lot of acute injuries in Urgent Care and ‘copious’ irrigation of wounds with good old tap water is our current go-to, although normal saline (0.9% saline slution) is slightly preferred as it’s not hypotonic… less damage to cells.

The purpose of irrigating a wound is to remove contamination without killing off the body’s own defensive cells. Irrigation both dilutes and washes away bacteria and particles.

The choice of irrigating fluids is critical, since many chemicals are toxic to white blood cells and new epidermal cells. A good rule of thumb is that a fluid is safe to use on a wound if you are willing to put it in your own eye.

As with any treatment, it is important to know the potential risks and benefits. Commonly used substances such as betadine, chlorhexidine, alcohol, Dakin’s solution, and peroxide actually have a toxic effect on wound healing and have the potential to cause more harm than good. Simple, plain, unsophisticated normal saline still holds the position as the standard irrigation for wounds, based on its long history of success and its minimal effect on the wound.

There are multiple articles relating to the amount of force needed to cleanse a wound. The goal is to rid the wound of foreign matter adequately without damaging the delicate and already injured (and, therefore, more susceptible to additional injury) tissue; simply pouring saline onto a wound creates about 4 pounds per square inch (PSI) of pressure, whereas irrigating the wound using a 30 cc syringe with an 18 g catheter creates about 15 psi.

While this is the standard regimen and pressure for cleaning a wound, other factors such as the type and amount of foreign matter, the adherence, and patient’s tolerance to the irrigation are all mitigating factors in choosing which method or irrigation is best.

Tegaderm is great, used as steelbikerider mentions above. Lots of wound drainage in the first 24 hrs, so changing at that point and then whenever there’s a big build-up of fluid underneath.

The Dermatology folks frown on Neosporin and such (some have an allergy to the antibiotic component in it), so they use a lot of petroleum jelly (aka Vaseline) to apply to wounds. Contrary to the previous ‘let it scab over’ approach, studies show wounds heal faster and with less scarring if kept moist with Tegaderm or Vaseline.

[djg21]

Originally Posted by mass_biker

JRA on a low traffic side street on a windy morning for a <1 hour constitutional…I reach back to tuck something into my jersey pocket that was working loose (taking one hand off the bar) when I hit a concealed (thanks, fall leaves!) dip in the road, and bang! down I go on my left side. Slow motion (self induced) wreck. Great. No head impact thank goodness. Some left crank and shifter scrape-age, and other than needing to bang the shifter back into place, the Ritchey is none the worse for wear.

On return to home base, the usual post-tumble evaluation and regimen ensued (got a few new holes and scrapes on the jersey, bust out the gauze pads with rubbing alcohol for the road rash etc.). So back to normal life (for a biker). Which means road rash management and regaining mobility around the joints of the ouchy spots.

Any best practices? I typically do Neosporin, and sometimes Tergaderm for the larger patches. And while I do intersperse running with cycling, I can’t fathom getting out there and pounding along (which means more on the indoor bike?) until less ouchy.

Eager to get folks’ feedback and guidance here.

MB

Not a joke. Makuna Honey works really well on abrasions and road rash (under bandages). https://pmc.ncbi.nlm.nih.gov/articles/PMC6613335, https://pmc.ncbi.nlm.nih.gov/articles/PMC7693943/

The higher MGO contents are better for medicinal use.

https://www.amazon.com/Certified-Hig...01HYIT7PO?th=1

[Dired]

Here's what I've been using for road rash, not sure of the source (i want to say NYCC) but it works very well:

1) Clean
2) Apply xeroform petrolatum gauze directly on the wound.
3) Cover the xf with non adhering dressing pads
4) Apply tegaderm over the entire area to keep everything in place.

The key is to layer the right materials in the correct order before applying Tegaderm.

Maintenance:
Leave until second layer becomes dirty in 3-4 days and repalce (back will need less maintenance).

[Alistair]

Originally Posted by thwart

Tegaderm is great

The Dermatology folks frown on Neosporin and such, so they use a lot of petroleum jelly (aka Vaseline) to apply to wounds. Contrary to the previous ‘let it scab over’ approach, studies show wounds heal faster and with less scarring if kept moist with Tegaderm or Vaseline.

This.

Tegaderm if the wound is going to make a mess, like Dired described above.

For smaller wounds, a dab of vaseline and a sterile gauze covering (changed regularly).

Both after irrigation/cleaing (but not with hydrogen peroxiee).

[HenryA]

For larger wounds, I like non-stick pads and Hypafix tape. Very comfortable and breathable.

Hopefully you cleaned the areas well. Best case is asap after injury. A warm shower and a clean washcloth is good. Clean it, let it dry and for the first day or three, neosporin or similar. After that keep it greased and covered until no bleeding on your clothes or it needs protection. Change dressing at least once a day, twice if you are active. Then grease it regularly until healed. Works for me.

[mass_biker]

A little goopy, but all contained in the Tergaderm. I’ll clean and redress tonight.
It’s not as sore around the joint and mobility is coming back slowly.
Weight bearing is working - yes! Still think another day+ of “easy does it” is warranted. Besides, isn’t Fall when you take your enforced break?
Last year it was my recovery from open heart surgery.
This is a lot less crisis inducing!
Thanks all
MB