Road Rash

For avid cyclers and skaters, there is nothing that can compare to the adrenaline rush, to the wind in their hair and faces, to the thrill of the sport… or to the pain and consequences of an untimely injury. While cycling is an excellent, low-cost and low-impact fitness activity, it carries plenty of risks for unpleasant mishaps. One of the most commonly occurring injuries is the shallow but painful skin abrasion referred to in the cycling world as “road rash.”

Road Rash & Scarring

When a cyclist or skater falls off of his or her bike, board, or skates, he or she makes damaging and often prolonged contact with the road as he or she lands on the ground and/or slides due to continuing momentum. While most abrasions are not deep or serious, they often remove several layers of skin and can be inordinately painful without excessive bleeding. If road rash is not treated promptly and properly, however, the seemingly harmless scrape can lead to more acute conditions.

Gauze Pads

Treatment

Cleaning the wound

The first step in successful treatment of road rash is meticulously cleaning the affected area. Road rash often results in small pieces of dirt, gravel, and other foreign bodies embedding in the skin. If the debris is not removed before treating the wound, it may remain there while new skin grows over it, leading to infection. Use a pair of clean (preferably sterile), precise tweezers to remove any and all fragments of dirt from the wound before cleaning. To remove smaller pieces of grit, gently rub the area with soft gauze (dampened with wound cleanser) to clean completely; do not scour the abrasion forcefully as that can increase pain and further the skin damage. Use a mild soap or wound cleansing solution to thoroughly irrigate the wound; if you have a medication syringe, squeeze bottle, or low-pressure faucet, using it to apply slight pressure to the scraped skin will be more effective than simply pouring water over it. Former cycling “wisdom” encouraged road rash sufferers to cleanse the wound with hydrogen peroxide; this practice has since been discontinued as it has actually been shown to kill new cells and impede healing.

Dressing the wound

Triple Antibiotic Ointment

After the area is cleaned completely, apply a thin layer of antibiotic ointment like Bacitracin or other triple antibiotic ointment or cream. These salves soothe the wound – some even contain pain relieving ingredients – and prevent bacterial growth and infection with their antibiotic properties. The application of ointment also keeps the wound moist, which promotes healing and decreases pain and scarring.

Cover the abrasion with a semipermeable dressing, which allows the wound to breathe without permitting dirt to enter it. It is important to choose a non-adherent, conformable dressing to prevent further damage and pain to tender, healing skin. Simple gauze pads may be taped to the undamaged skin surrounding larger areas of road rash for clean coverage; a more convenient dressing for smaller abrasions is 3M’s Tegaderm™ +Pad Film dressing, which is composed of a breathable, non-adherent, sterile pad and stretchy waterproof film for comfortable wear over several days. Another good choice for road rash dressing is a hydrocolloid bandage, which responds to wound fluid with a healing gel, keeping the wound moist and protected.

Tegaderm+Pad Film

The dressing and ointment should be changed regularly – every few days – until the road rash is completely healed. More shallow areas of abrasion, such as those around the edges of the wound, will heal faster; deeper injuries will require more time to heal fully. It is crucial to keep up a wound care regimen until the rash is entirely healed to prevent infection or scarring, especially in delicate facial wounds.

Do I need to see a doctor?

While most occurrences of road rash are painful, they are typically not dangerous. There are, however, some occasions in which proper medical treatment for road rash is recommended.

Tetanus

Many people know that they can contract tetanus – an infectious medical condition affecting the muscles – from stepping on a rusty nail, but are not familiar with the fact that tetanus can be caused by improper wound care as well. Tetanus bacteria often gathers in other outdoor locations as well and may very well find its way into deep or puncture wounds, which may occur in cycling accidents. If you are unsure of your tetanus status or know that you are not up-to-date on your vaccinations, you should visit your doctor after a bad fall.

Infection

It is of utmost importance that one is familiar with and able to recognize the signs of infection. If a wound is stiff, hot or has red streaks radiating from it, or you are experiencing numbness, nausea or fever, see a doctor immediately. These are signs of serious infection and if the infection is not treated properly and promptly, it may lead to compartment syndrome (a life-threatening condition caused by excess pressure on muscle compartments, often due to injury swelling) or cellulitis (tissue inflammation caused by bacteria entering through broken skin).

Stitches

Some deep cuts and abrasions will require stitches. If the wound does not stop bleeding after 15 minutes of continuous pressure, if its edges pull apart, or if it gapes, it may need to be stitched to heal properly. If a wound looks especially deep, particularly if it is on the face or other sensitive area, a trip to the doctor is recommended.

Prevention

Because road rash is one of the most common injuries in outdoor activities like cycling, skateboarding, and roller skating, it is important to know how to properly care for it. To save oneself a lot of pain and inconvenience, though, it is just as crucial to know how to prevent it from happening in the first place. Bikers and skaters should don a helmet, protective pads on commonly injured areas such as knees and elbows, and long sleeves and pants to add a barrier between skin and the ground. It is far more preferable to tear clothing than to tear skin!

Anyone who plays sports or participates in any athletic activity should be prepared to deal with injuries. At Tiger Medical Supplies, we are fully stocked with the supplies necessary to care for road rash – wound cleansing solution, gauze, tape, dressings, and ointment – and for other sports-related ailments.