first aid for deep abrasions

as far as i know, you're supposed to not let it scab up. keep it "wet"
and covered with gauze. use one of those antiseptic salves. maybe
call up the advice nurse at the local hospital?

just a reader said:

Other than cleaning well with isopropyl alcohol what kind of first aid
should you use for deep abrasions? Are there any techniques you guys
use so that the scar tissue doesn't limit knee/elbow mobility
later? With an abrasion such as the one below where skin is gouged
out you really can't get it stitched so what do you do?

http://img213.echo.cx/my.php?image=abrasion10ly.jpg

See your Doctor and see if he/she will prescribe some Silvadene cream.
It's primary use is for severe burns but it works wonders on road-rash
(personal exp.).

--
Roy Owen

Keep the leather side up,
and the rubber side down.

just a reader said:

Other than cleaning well with isopropyl alcohol what kind of first aid
should you use for deep abrasions? Are there any techniques you guys
use so that the scar tissue doesn't limit knee/elbow mobility
later? With an abrasion such as the one below where skin is gouged
out you really can't get it stitched so what do you do?

http://img213.echo.cx/my.php?image=abrasion10ly.jpg

First, you shouldn't use alcohol or hydrogen peroxide to clean
wounds. They are no more effective than soap and water and may damage
tissue and delay healing.

It is sort of hard to tell in your picture, but it looks like you have
completely removed the skin in the center of your wound, where the red
beefy spot is. That is usually recomended as the point where you have
somebody take a look at it.

If you can't or won't have it looked at, the basic idea is to keep the
wound moist and to avoid infection. The two ways to do this are
either a little antibiotic cream and a non-stick dressing changed once
or twice per day, or an occlusive dressing like Tegaderm changed every
few days. No antibiotic is needed with the Tegaderm. Silvadene is
often used as an antibiotic for burns, but regular polysporin
available at the drug store works fine.

If you haven't had a tetanus booster in the last 10 years, or don't
know when you last had one, then you need to go get one.

If your wound starts to look infected you should get help.

If there is no skin in the middle of that wound, expect it to take a
while to heal, as new skin only grows from old skin, so the middle
will have to fill in from the edges. That sort of healing also tends
to leave more of a scar.

On Mon, 20 Jun 2005 13:59:38 -0700, "(PeteCresswell)" <[email hidden]>

Quoted message said:

Per just a reader:

Quoted message said:

Other than cleaning well with isopropyl alcohol what kind of first aid
should you use for deep abrasions?

That looks a lot like the one I managed to get last year - jumped an itty-bitty
log, somehow did a face plant, impaled the knee on a little deadhead on a nearby
log.

Isopropyl alcohol ?!!!!? Yer a better man than I. A true stoic.

I carry a squeeze bottle full of betadyne. On that one, I just sort of filled
it up with the stuff, massaged it a little to get full coverage, hosed it out
with water from my water bottle, and then gave it another shot of betadyne.

Been doing the betadyne thing since (IMHO...) almost dying from a lousy little
sandpaper scrape in Hawaii many moons ago. Face blew up like a balloon,
fingers like sausages, can't remember anything for almost a week... I'm guessing
some kind of systemic/kidney infection from the then-walnut-sized area of
infection at the site of the scrape.

The med tech that I finally went to get last year's puncture properly closed
didn't like the idea of betadyne. Said it killed too much tissue.

My take: in the light of antibiotic-resistant infections/flesh-eating
bacteria/necrotizing faciatitis a little extra tissue damage is nothing compared
to the possible consequences of an infection by the really bad guys - as in limb
amputation or death. Couple years ago one of the local roadies took a spill,
rode home, wound up in the local hospital getting a leg amputated - so the stuff
definately is present in the Southeastern Penna environment.

Cleaning the road grit out from under the edges of the wound with
isopropyl alcohol was painful. As you pointed out the sooner you
clean the wound the better and isopropyl and iodine were the only
thing I had on hand.

Roy Owen said:

just a reader said:

Other than cleaning well with isopropyl alcohol what kind of first aid
should you use for deep abrasions? Are there any techniques you guys
use so that the scar tissue doesn't limit knee/elbow mobility
later? With an abrasion such as the one below where skin is gouged
out you really can't get it stitched so what do you do?

http://img213.echo.cx/my.php?image=abrasion10ly.jpg

See your Doctor and see if he/she will prescribe some Silvadene cream.
It's primary use is for severe burns but it works wonders on road-rash
(personal exp.).

Looks like good stuff, they even use it as a pretreatment to areas
that are to receive skin grafts. As serg said keeping the area from
scabbing too quickly may help. Would be nice if I can get it to stop
bleeding first though.

"just a reader" <[email hidden]> wrote in message
news:[email hidden]...

Quoted message said:

Other than cleaning well with isopropyl alcohol what kind of first aid
should you use for deep abrasions? Are there any techniques you guys
use so that the scar tissue doesn't limit knee/elbow mobility
later? With an abrasion such as the one below where skin is gouged
out you really can't get it stitched so what do you do?

http://img213.echo.cx/my.php?image=abrasion10ly.jpg

The best article I have seen for dealing with road rash is at

http://www.velonews.com/train/articles/3909.0.html

Per just a reader:

Quoted message said:

Other than cleaning well with isopropyl alcohol what kind of first aid
should you use for deep abrasions?

That looks a lot like the one I managed to get last year - jumped an itty-bitty
log, somehow did a face plant, impaled the knee on a little deadhead on a nearby
log.

Isopropyl alcohol ?!!!!? Yer a better man than I. A true stoic.

I carry a squeeze bottle full of betadyne. On that one, I just sort of filled
it up with the stuff, massaged it a little to get full coverage, hosed it out
with water from my water bottle, and then gave it another shot of betadyne.

Been doing the betadyne thing since (IMHO...) almost dying from a lousy little
sandpaper scrape in Hawaii many moons ago. Face blew up like a balloon,
fingers like sausages, can't remember anything for almost a week... I'm guessing
some kind of systemic/kidney infection from the then-walnut-sized area of
infection at the site of the scrape.

The med tech that I finally went to get last year's puncture properly closed
didn't like the idea of betadyne. Said it killed too much tissue.

My take: in the light of antibiotic-resistant infections/flesh-eating
bacteria/necrotizing faciatitis a little extra tissue damage is nothing compared
to the possible consequences of an infection by the really bad guys - as in limb
amputation or death. Couple years ago one of the local roadies took a spill,
rode home, wound up in the local hospital getting a leg amputated - so the stuff
definately is present in the Southeastern Penna environment.
--
PeteCresswell

Roy Owen said:

just a reader said:

Other than cleaning well with isopropyl alcohol what kind of first aid
should you use for deep abrasions? Are there any techniques you guys
use so that the scar tissue doesn't limit knee/elbow mobility
later? With an abrasion such as the one below where skin is gouged
out you really can't get it stitched so what do you do?

http://img213.echo.cx/my.php?image=abrasion10ly.jpg

See your Doctor and see if he/she will prescribe some Silvadene cream.
It's primary use is for severe burns but it works wonders on road-rash
(personal exp.).

Pardon me for launching off Roy's response, but I missed the OP.

That photo is [censored].

Deep abrasions need to be cleaned, which often involves scrubbing.
Antiseptic followed by antibiotic with sterile dressing to be followed
to promote moist healing. Good results will follow. No debridement or
stiches necessary.

Robin Hubert

Most ER Doc's would throw a stitch, if nothing else than to get a good
secure closure on that part of the body. And Yes, they can get it
stitched, under/over style.

Anything less is just playing doctor with your own body.
-r

email hidden said:

Most ER Doc's would throw a stitch, if nothing else than to get a good
secure closure on that part of the body. And Yes, they can get it
stitched, under/over style.

Anything less is just playing doctor with your own body.
-r

I agree, skin is pretty stretchy and a stitch would stop the bleeding
quicker. Unfortunately my primary care physician was not available
to authorise a visit to the ER. Most insurance plans require prior
authorization before an ER visit and this was not a life threatening
injury. Emergency room visits routinely run over $700 so controlling
bleeding with sterile gauze for a day or two is an option worth
weighing.

just a reader said:

email hidden said:

Most ER Doc's would throw a stitch, if nothing else than to get a good
secure closure on that part of the body. And Yes, they can get it
stitched, under/over style.

Anything less is just playing doctor with your own body.
-r

I agree, skin is pretty stretchy and a stitch would stop the bleeding
quicker. Unfortunately my primary care physician was not available
to authorise a visit to the ER. Most insurance plans require prior
authorization before an ER visit and this was not a life threatening
injury. Emergency room visits routinely run over $700 so controlling
bleeding with sterile gauze for a day or two is an option worth
weighing.

and not beyond reasonable care .... I've had several "stitch-able"
offenses in my life, but no stitches (or staples, or debridement - 'sept
my own ....). I'm not advocating avoiding proper medical care. I'm
just saying many skin wounds can be personally addressed. Prudence is
required!

Robin Hubert

just a reader said:

Most insurance plans require prior
authorization before an ER visit

The hell? Isn't the whole point of the ER that it's for things that
*can't* wait?

Jasper

Jasper Janssen said:

just a reader said:

Most insurance plans require prior
authorization before an ER visit

The hell? Isn't the whole point of the ER that it's for things that
*can't* wait?

Welcome to the You-Ess-of-Aye, where medical care is a for profit industry.

--
Sock Puppet

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Jasper Janssen said:

just a reader said:

Most insurance plans require prior
authorization before an ER visit

The hell? Isn't the whole point of the ER that it's for things that
*can't* wait?

Don't recall seeing that first post (in JUNE), but it's wrong. Virtually
every insurance plan that I've seen recommends calling 9-11 or going to the
ER in the event of an emergency -- if for no other reason that to cover its
own ass.

BS

Bill Sornson said:

Don't recall seeing that first post (in JUNE), but it's wrong. Virtually
every insurance plan that I've seen recommends calling 9-11 or going to the
ER in the event of an emergency -- if for no other reason that to cover its
own ass.

But while recommending it, do they actually *cover* it? A document saying
"If you think you may be ill, go to the ER! But, err, if we later
determine that despite having all the symptoms of something serious, it
was actually indigestion, here's your $8000 bill." isn't in reality much
of an encouragement.

Jasper