Road rash can often be the most painful part of an off, but it shouldn’t ruin your adventure. Doc Edwards discusses how to properly treat road rash on your next adventure.
Before we begin treatment for road rash, the first thing you should do after any crash is determine the extent of injury. Did you break anything, hit your head, do you have any joint swelling, difficulty breathing or moving about? If so, you likely need proper medical assessment.
Assuming that all of the above is fine and we are now looking at your wound. Can you see beneath the skin? Can you see something that looks like fat or muscle? Can you see tendons? Has it been a long time since your last tetanus shot? If the answer to any of the above is ‘yes’, you need to see a doctor. Nothing disrupts a great adventure experience like having to look for urgent care or a hospital, but it’s sometimes necessary.
First aid kit
Everyone should carry some sort of a first aid kit on an adventure ride. What supplies you are going to carry depends on how much space you can spare. If room is limited, you should still carry the essentials. If you are riding in a group, consider designating two or three people to carry enough supplies to treat a couple of riders. I recommend making your own kits and using products that you can get at any pharmacy.
Abrasions that do not penetrate through the skin layer can be self-treated. The goal is to clean the wound thoroughly. First aid solutions for washing wounds basically contain soap and water, the best products are those that contain soap and a pain killer such as lidocaine or Brulidine. Let the painkiller solution soak on the wound for at least ten minutes, making the skin numb and the wound essentially pain free. If you don’t have any of these solutions, use soap and water.
First of all cover the wound. Just use regular, non-adherent dressings. The wound is going to ooze for at least a couple of days and you will be performing daily dressing changes. Secure with quality cloth or clear tape.
A gauze wrap is something that keeps the bandages in place while you are moving about, on or off the bike. Look for those with absorbent properties so they can soak up wound drainage. Ace bandages can work as well, but they tend to unravel quite easily. In my experience, the best wrap is a product called Coban – which is short for cohesive bandage. I use this for my riders during the Dakar rally or other adventure tours. It’s tough and it sticks to itself and can be reused.
Semi permeable dressings
Tegaderm is a very thin, clear dressing with adhesive on one side. It is very good at keeping the wound clean and lets the skin breathe. Another reason I like Tegaderm is that it takes away the painful skin sensation and allows for a better night’s rest, optimising recovery. This can be essential during a rally or long adventure ride. Hydrocolloid dressings are thicker and provide more protection for the wound. These are usually advanced dressings but can be well worth the time and effort.
During the 2007 Dakar rally, Chris Blais presented with the worst case of gluteal and perennial abrasions (monkey butt) that I had seen in a long time and it was really affecting his ability to concentrate and sleep. I managed to procure some of this hydrocolloid dressing from the medical organization in Morocco and applied it to Chris’ arrière. He even kept it on while riding. Amazingly, within one day his wounds looked a hundred percent better and he complained of zero pain. Chris went on to finish third overall in the rally that year.
It is always a good idea to keep zip lock bags on hand, as they can be used to store your supplies. They also come in very handy if you have access to ice so you can use them as an ice pack.
Other essential items are cutting devices. Scissors are nice, but you can usually get the job done with a knife.
How to clean the wound
Photo: Jonathan Cohen
1. Numb the injury with antiseptic wash by applying solution to a gauze and holding it over the wound for about ten minutes. Patience is the key here.
2. When the pain is reduced, use more soaked gauze pads to gently scrub the abrasion. Don’t overdo it, just scrub the dirt out as best as possible. I always advise to avoid hydrogen peroxide as it hurts like a dickens and kills the good tissue. If you find there is grease in the wound, apply a dish soap solution. You must remove all of the debris as this can lead to an infection and permanent discolouration. If you can’t, then seek more advanced medical care.
3. After the wound is reasonably cleaned, consider applying a light layer of antibiotic ointment such as bacitracin or Brulidine (assuming that you are not allergic). Start with a non-adherent dressing, as the wound will ooze, then wrap with Coban. Then tape the wrap for extra security. Over the next couple of days the oozing will slow down and then you can change to a semi permeable dressing.
4. If you’re going to continue riding, use the method above, but be sure to wrap the wound very well with Coban or an ace wrap. Tape it securely, even use duct tape if necessary. Always be sure there is adequate range of motion, as with most dressings, it will work its way loose.
5. It’s normal to keep the wound covered for five to 10 days and full healing may take some weeks. Replace the dressings as needed and each time gently clean the wound with soap and water. The abrasion will form a whitish plaque which is called granulation tissue. Try not to peel it off or let it dry completely; wounds have been found to heal slower when you do this. Finally remember that new skin is extremely sensitive to sunlight, so always cover it and use sun screen.
The information provided in this article does not constitute formal medical advice. Always check with your own doctor to see if the information provided is appropriate for you. The information in this article applies to general medical practices and may not reflect current medical developments.