How to treat road rash

September 17, 2019 4 min read

How to treat road rash

If you are serious about cycling, chances are you’ve come off your bike at least once already. Unfortunately it’s part and parcel of the sport that if you spend enough time riding on the road, you’re also going to get up close and personal with it at some time.

Usually the outcome is some lost skin, maybe a broken collarbone  from the impact and friction when you hit the deck along the road, with you or your bike coming off worse for wear.

Before you get back on and shakily take yourself home it’s important to check yourself and your bike over carefully. The adrenalin that comes from the shock of a fall can mask the pain of other injuries. Bone breakage, serious bruising (including bone bruising), spinal injuries and concussion are all factors that need treatment as early as possible. No matter how light your fall, if you were going at speed get to a hospital and get checked over, even if it’s just for the safety of a tetanus shot. 

It’s important to wear gloves to protect the skin of your hands from road rash, skin off your back, buttocks or legs is bad enough, but your hands are something you use constantly and will be relying on, and difficult to cover or keep dry. 

Even though road rash can be a relatively minor and inevitable from a tumble it can still be hard to know how to treat it. Roads are dirty, gritty and rough, meaning you not only lose skin, but you also pick up a wealth of black stuff that becomes embedded in exposed flesh. 

At the scene

Do what you can to stop any bleeding by applying pressure. Get to a doctor or outpatient facility as soon as possible to get the wound correctly cleaned and dressed as well as to check for more serious injuries. 

Scrubbing

Healing isn’t pain free. In order to get that gravel, grit and dirt out of your wound so it can heal safely you will need to remove it (or have it removed for you). The best way for this to happen is by scrubbing out all those obvious pieces of road. 

When the wound is clean more scrubbing is needed with a saline solution or other sanitising treatment like betadine or iodine. 

The next 24 hours

Because the wound is at its most fragile after that harsh treatment it’s time to cover and rest. Use an iodine gauze to help keep the wound clean and fight off infection. 

Dressing

It’s okay to keep training (or racing) as long as the wound is properly dressed. There are a few different aims with the dressing, one is to absorb liquid oozing from the wound and trap any bacteria that it may contain, and the other is to provide hydration so that the scab stays soft. The same dressings may also contain calcium to help slow bleeding. 

Examples of dressings that provide the ultimate condition for faster healing are those containing silver and alginate. Alginate dressings are similar to a dry weave bandage but are able to absorb up to 20 times their own weight. 

As fluid seeps from the wound the dressing absorbs it, becoming like a gel. 

Keep covered

Airing your wound will cause the scab to become hard, protecting it from infection and stopping it from weeping, which means you won’t get stuck to bed sheets and clothing, however, research shows that hard scabs hinders new skin growth. The best remedy is to keep the scab soft to help promote skin growth and reduce scarring, but that means you need to do more to help protect from infection. 

Stay covered up.

Here’s how to apply an alginate dressing. 

  • Apply a saline solution to clean the wound
  • Dry the area around the wound.
  • Apply the alginate dressing and secure in place with a standard bandage or tubular gauze.
  • Add more dressings to cover the whole damaged area if necessary.
  • You will need to change the dressing every one to three days. You will notice fluid seeping from the edges when it has reached capacity.
  • Before you remove the dressing, dampen it with a saline solution so it comes away freely. 

Riding

If you want to (or need to) get back on the bike soon after your fall you can do so but it’s essential that you help your body out during this exhaustive healing process. Your blood cells are busy knitting, fighting and building, which all takes significant energy. To help things along make sure you eat (or drink) plenty of protein, which has the building blocks your body needs to make repairs. 

Make sure you continue to eat healthy well-balanced food that has a variety of whole grains, fruits and vegetables so your immune system gets the boost it needs to keep you strong and your blood is rich with nutrients.     

Get plenty of sleep. This is when the majority of the work will be done to reconstruct your tissue and skin. 

Before you get back on your bike check the frame and spokes over carefully for cracks or damage that might make it dangerous to ride. 

Keep cleaning

Another reason to keep the scab soft with alginate dressings is so you can continue to clean grit and gravel out. Your body will naturally push deep laying road debris to the surface so even though you may have effectively removed all the pieces, more grit may surface over the next few days (or weeks, depending on how bad the fall was). A soft scab will allow you to keep cleaning out the foreign pieces. 

While falls are not a regular part of cycling, they are something you need to expect from time to time. Always wear a quality bike helmet and check yourself and your bike carefully after an incident to be sure everything is safe to continue. 

Getting on the road to recovery after a fall, fast? That’s freedom! 


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