It’s summertime (Hallelujah!) and with that comes an increased risk of injury. Ever fall off a bike? Scrape yourself on a rock? Get the lawn mower too close to a tree? You know, these things happen, no matter how careful we are. I’m not just talking about bikes or small scratches, I’m talking about it-hurts-to-wear-clothes, can’t-bend-my-knee, wound-is-seeping-pus and must-buy-more-guaze types of cuts, scrapes and road rash.
As you probably expect, many of my posts come from personal experience – things I’m going through, have just learned or am trying to figure out myself. This week, we’re talking wounds because of mountain biking. This one isn’t so much personal, as it’s my husband who’s sitting up in his office right now without pants on (sorry for the mental image) because his wounds from Wednesday night’s bike race/crash-fest has left him in some serious pain. It was a race in a bike park, with lots of corners and a downhill curvy and bumpy section called a corkscrew. The corners were slick, it was dusty and dry and he was racing a cyclocross bike on terrain better suited for a mountain bike. Suffice it to say he crashed twice, ending the race with two bloody legs, ripped shorts, a bloody hip, frustration and pain. Luckily there was a first aid tent, so someone with experience could clean up the bloody, dirty, dusty woulds and bandage him up. But then we got home and realized neither of us knew how to properly care for these things.
Here’s what we’re dealing with:
(P.s. I decided against photos since these are pretty gross looking – so use your imagination)- Hamburger sized raspberry on the outer hip/buttocks area
- Deep wound on the knee which spreads down to moderately deep scratches down the calf – also a silver-dollar sized area without skin
- Mild scratches on the calf (of the other leg), not deep at all
- Quarter sized area of scratches on the ankle
On the way home from the race, we stopped at our local Walgreens to get supplies. I stood there, helpless almost, trying to figure out what we needed. Gauze pads, gauze dressing, wrap, tape, bandaids, self-sticking, no-stick…..not to mention three or four brands of each. I attempted to duplicate what was currently protecting the wounds, so ended up with gauze dressing (the thicker stuff to handle moderate weeping – which we had) and wrap to hold the gauze in place. $10 later, I was satisfied with my purchases. When we got home, I had to play nurse. Let’s just say I got confirmation that that was not a career path for me. I almost threw up dealing with the deep wound on the knee. It was like ground beef! I carefully covered the weepy wounds with gauze and secured them with the self-sticking wrap. A little duct tape to secure the end and we were set. At least that should keep the sheets clean during slumber.
The next day we went to the bike shop and were told the real way to care for these injuries. Bikers know. This stuff is common in mountain biking I guess. It’s all about moisture (anti-bacterial ointment) and getting the big bandaids (because they don’t stick like gauze does) and keeping it covered. Intuitively, I would keep it uncovered during the day to allow air in to speed healing, but what do I know?! My first thought was to find a plantain leaf and apply tea tree oil. This conversation led me to do some investigation into the easiest, and best way to care for this type of wounds.
Step-By-Step Guide to Treating Cuts, Scrapes and Road Rash
Note: if your wounds are really deep, bleeding profusely or cover a large part of your body, consider seeking medical attention either at a first-aid station (if racing) or the ER. You might need stitches for deep wounds. Never underestimate your injuries, especially if you suspect broken bones. Also, if you haven’t received a tetanus shot or booster within the past 10 years, consider visiting your doctor to get the booster. There is your necessary disclaimer.Step 1:
Clean the impacted area, like really clean it. It’s unpleasant, but you need to get all dirt and debris out of the wound. Leaving this stuff in could lead to infection or weirdness as you heal. I once knew someone that had a rock under their skin from a wound and they’d move the rock around…it could be a fun party joke, but otherwise, it’s not necessary – get it out.
The most common way to clean wounds is with hydrogen peroxide. Research told me there is some debate about this, but I doubt it’ll ever stop being the common cleaning agent. It’s cheap and most people have it around, so it’s the go-to for cleaning. Two antiseptic products I saw refereed to frequently are 0.9 sodium chloride and Shur-Clens. These might be worth having on hand if you fall often (I might have to invest in some). If you can get your hands on iodine scrubbers, that is ideal (and what first aid used on Erik’s wounds). Another option is simple soap and water. Be sure the soap is as natural as you have on hand. I’d avoid any fragrances, color, etc., because you want simple cleaning without adding funky stuff directly into your bloodstream. You an also use clean gauze pads to gently (key word gently) clean the area. Don’t scrub, but scrub – you follow?
The cleaning process will hurt because you’re digging in and messing with broken skin. There is no way that would be fun, but it’s a necessary part of the situation.
Step 2:
Keep the areas moist and covered. This is counterintuitive for me, and I suspect with others as well. I feel like it should scab, be exposed and heal nicely. Apparently, this isn’t the case for these types of wounds. Both the bike shop guys and the internet (which is always correct, right?) tells me to use an anti-bacterial ointment to keep the area moist. Moist skin heals easier with less scarring and the ointment helps prevent infection. Skin that scabs is less exposed to air and has less healing ability. Plus, scabs are tight and itchy and crack all the time, leading to more pain and longer healing times. Choose a natural antibiotic ointment if you can find one – a combination of natural oils (jojoba, tea tree, etc.) are great and more natural than a lot of stuff on the market.
To cover the area, use gauze or some sort of product designed for this. The bike shop guys kept saying Tegaderm, which is a product kind of like gauze but doesn’t stick to the wound as much. It appears to be self-adhesive so it stays in place nicely. There are other products available here too, or use what you have on hand.
For a scraped up area that is minor (you will know the difference), I think it’s ok to apply ointment and not cover the area. These types of wounds will take less time to heal and aren’t as susceptible to infection. For deeper wounds or those where all the skin is scraped off, keep it moist and covered. The key really is moisture and the covering is protection, so you may be able to discern for yourself here. It also depends where the wound is. For the hip, with the risk of clothing rubbing, keep it covered.
Step 3:
Change the dressing every day. Reapply your moistening agent and put a fresh cover on the wound. For deep wounds that bleed, change the dressing whenever it becomes noticeably soiled. You want to keep things fresh.
Step 4:
Start the healing! Once you have set yourself up for successful healing, don’t do anything to further harm yourself. Stay off your bike or skateboard or whatever it is for a couple of days. Avoid strenuous activities that activate the area too much, especially when the injury is on a joint. Take care to not bump or hit your wounds. If you feel tired, rest. Your body is working overtime to heal and giving it that space is ideal. Your wounds will heal from deep to superficial (think of bottom up) and outer to inner. Be patient with the healing process, it might take a couple of weeks.
Any other suggestions out there? Feel free to add them in the comments.