Thoughts from a PHD in road rash
originally this was an email to well known Canadian inliner Herb Gayle, Herb had a friend who had nicely hamburgered themselves, and emailed his whole email list for advice, this was my reply to the discussion that popped up among Herb's friends.
I have some serious thoughts to add.. I too have felt what you feel, looking at your friend in pain, this is my response..
As a survivor of over 400+ bicycle races, and close to 100 speedskating races, I have had the (mis)fortune to have a lot of experience with nasty road rash, including one that was categorized as a second degree burn that stretched from my right ankle to the knee, and numerous others that started with falling from the bike at 30+mph and cartwheeling across the asphalt, leaving skin as I go.
So I have had much opportunity to practice various methods of road rash healing.
My proof that I have something to add to this discussion, is that if you have met me, you see that I am very fair complexioned and am basically wrapped in a carpet of freckles. On me, scars REALLY stand out. Ever noticed any scars on me at races? no? exactly!. I have learned how to make sure they DON'T happen. If I had not taken good care of my road rash, my legs (and shoulders too) would be a horrific mess. Never got any on my face, but 4 broken helmets over the years have done their job.So I gotta add my quick 2 cents to this discussion(and that is 2 cents in american money.. ha ha ha)
first of all, when I comes to road rash, if you want a disfiguring scar, then ignore your road rash and let it scab over and get full of linty crap.. even small bits of rash, ignored, can end up be permanent, Just above my right elbow, I once got a small piece of rash from a fairly minor 10 rider pileup, it was only the size of a penny, so l ignored it. 15 years later, the scar is still there, like a meteor impact in a field of freckles.
I DON'T RECCOMEND HYDROGEN PEROXIDE UNLESS THE WOUND IS REALLY FULL OF DIRT AND SAND AND WATER, AND THEN YOU HAVE TO DISINFECT IT, PEROXIDE KILLS THE TOP LAYER OF SKIN CELLS!! (along with everything else)
if your crash was cause you were racing in the rain, and then you finished the race and your legs are covered in blood and miles of road slime and other goo, or if you created your road rash in a mountain bike race, and you finish with dirt and stream water mixed in with the blood & sweat in your wound, yeah, its peroxide time..
But in general , Peroxide slows healing, damages your body, but it will prevent a good deal of contamination, but if you just skip across clean pavement, just lightly pat the wound with moist gauze, and you will be fine... if the wound later feels a little infected, yeah, peroxide also will help at that stage, but avoid it. pay attention to your wound, if there is any smell or heat, and you might have an infection on the way...
I used to go through a whole bottle of peroxide every year, I always thought the makers of peroxide and bactine should sponsor a bike team, its good to have on hand, try to never use it. SOME PEOPLE WANT TO USE ALCHOHOL ON YOUR WOUND, NO NO NO!! HOWEVER IF YOU LOVE TO HAVE PAIN BE SO BAD FOR NO REASON IT MAKES YOU SING LIKE A DRUNK PATRON OF A KAREOKE BAR, THEN GO FOR THE ALCHOHOL!! (I was in the middle of an emt forcing it on everyone who was in a 15+ rider pileup once, and it was horrible to hear the noises coming out of people, I recommend singing something instead of screaming. it feels better, makes people laugh, showing my age, I have gasped out a few lines of "the love boat" theme song)
FORGET ALL THE EXPENSIVE REMEDIES & SECOND SKIN STUFF:
buy a really big bottle of vitamin E softgels and some band-aids, every morning and night, puncture a softgel with a pin, and squeeze it over the wound, cover wound with band-aid... repeat at least once, and ideally twice, a day... keep the wound area covered and moist! and be religious about it!! keep this up all the way until healing is done, and you will have no scar. sometimes the vitamin E gets gooey around the edge of the wound, where its just sitting on unhurt skin, clean that off, keep the E on the wound, KEEP IT MOIST AND OOZY, THAT IS GOOD IF YOU HAVE A REALLY HUGE AREA OF ROAD RASH, LIKE THE SIZE OF YOUR HEAD, OR BIGGER, OR IF ITS VERY DEEP & YOU CAN SEE "STUFF" THAT DOESN'T LOOK LIKE ANGRY SKIN, YES, ITS TIME TO CHECK IN WITH A DOCTOR. ALSO VERY DEEP BRUISING, THAT SOMETIMES COMES ALOMNG WITH DYNAMIC CRASH AND ROAD BURNS, SEE A DOCTOR, THERE ARE "OWIES" AND THERE ARE "INJURIES" ROAD RASH IS A POWERFUL "OWIE" BUT CAN MASK DEEPER INJURIES.
Like being in a car crash, crashing really hard on skates or a bike, sometimes creates tremendous shock and impact to the body, its not a bad idea to take a nice hefty dose (I am 190lbs and use 1000mg) of ibuprofen a couple of times the day of and the day after your crash. It helps deal with the swelling and basic body "yeeeoowwch" factor. Ever crash and wake up the next day and find new areas that ache and hurt? that did not hurt the day of the crash? this helps....
Also, shaved legs are not just more aerodynamic, sexier and easier to massage, shaved legs are much easier to clean after accidents, and keep clean in the healing. In my experience, shaved legs lose less skin, and do not tear as badly as hairy legs when you hit the pavement. Shaved legs are more likely to skip across the asphalt, like a stone on water, especially in the rain. Hairy legs grab and tear. Last year, during ice speedskating season, I let myself get nice and furry again since my legs were not seeing any asphalt or sun. First sunny day bike ride of last year, first corner of the year, I was not paying attention, leaned into a corner, hit a stone at he exact wrong moment of deep lean and WHAM!!! yes, hairy legs can create bigger rash. I had forgotten that one. The second skin products can work wonders, especially on blisters, but I don't like them for road rash for one HUGE reason, if an infection does start, with a second skin, especially one that you leave on for days, you don't know its infected until the wound starts to HURT OR GET HOT, and by then its really pretty infected. The smell and visual things you notice as a wound is just starting to get infected when you are changing your own bandages twice a day, that is crucial info, mix a little triple antibiotic in with the vitamin E, that will take care of a beginning infection..
Better to do that, then removing a second skin product, and having the wound really angry and have a horrible smell hit you. Have this happen to you just once, and the memory will make you think twice about these products (that said, the band-aid second skin blister care is terrific when you have to train with a blister, but for big road rash, that's different)
I am sorry for this long missive, but Herb, I too have felt what you feel, looking at your friend in pain, this is my response.