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Suggestions to ease Road Rash healing itching?

Joe MatchetteJoe Matchette
in General Training Discussions

 Hello Team,

It has only been 36 hours since my unfortunate slide across the asphalt (http://preview.tinyurl.com/3sfz29j).  Thankfully I am starting to heal and the worst is pretty much scabbed over.  I was wondering if anybody has suggestions on what will alleviate the intense desire to scratch the parts that are scabbing over.

Ideas anyone?

Thanks,

Joe

Comments

  • penlynwilsonpenlynwilson
    Silvadene! Rx required but it is magical stuff. I took off the outside of my left calf on the velodrome. This stuff healed it without scarring.
  • Joe MatchetteJoe Matchette
    Penny - I guess I will have to go see a doctor. Being a pilot, I am fundamentally predisposed to avoid doing so at all costs. image
    Thanks!
  • Ralph ButlerRalph Butler

     Bacitracin will work well just slather a bunch on.  We use that instead of silverdene in cosmetic areas (face) aquaphor works well too.  .  You can also buy Tegaderm dressings, they look like plastic wrap and cover the wound and it will act like a large blister.  Just drain the fluid with a needle or some small poke hole to make the dressings last a couple days.  

  • Joe MatchetteJoe Matchette
    Thanks Ralph.
    @All - anyone ever have edema as a side effect of road rash? My lower right leg is quite edemic. It is looking like an 'old man leg' right now. I have a compression sleeve on it (which helps hold the dressing/bandage) and my feet are elevated. I definitely wasn't expecting edema. Itching -- yes. Swelling -- no.
  • Scott AlexanderScott Alexander

    Kitima gave me this earlier this year when I went down:

    Sounds like the road rash has scabbed over. You have 2 choices: you can leave it alone and eventually skin will grow under the scabs (like we did when we were kids with scraped knees) or you can to treat it with antibiotic ointment and keep it covered. The scab will soften up and slough off. The wound may LOOK worse as it will be moist and gooey, but ultimately that is the best and fastest way to heal a wound (by having it be in a moist, but not wet, and clean environment). I would recommend the latter.

    You can shower and get it wet---so yes, it's okay to swim in a chlorinated pool. I would not swim in open water until the skin has grown over the wounds---unless it's the ocean. If you can stand it, take an old wash cloth and gently scrub the road rash and scabs when you are in the shower. Taking off the scab will help the epithelium grow back faster. It's okay to get soap and water on it, but don't wash the wounds with alcohol, peroxide, bleach (yep, some of my patients think it's a great idea to wash their wounds with dilute bleach), or hibiclens (a surgical prep). Those chemicals will kill bacteria, but also damage and kill healing cells.

    If you find that the dressing is sticking to the wound, you can use Telfa (sold over the counter in pharmacies) or you can get in the shower with the whole dressing and let the water softening things up before peeling it off.

    If you have any swelling, redness, or pus draining from the wound, see you doctor right away as you may have an infection.

  • Joe MatchetteJoe Matchette
    @Scott - Thanks for passing that on. Based on this, and last night's chat, I will be getting some ointment and dressings so I can keep it moist.
  • Joe MatchetteJoe Matchette
    @All - I went to go see the Flight Surgeon on Tuesday. Based upon the advice received in the Haus, I told him I wanted a scrip for Silvadene cream and as many Telfa pads as I could get. So far, the road rashs healing very nicely.

    What is still sore are my ribs. I did not get X-rayed (didn't ask for it), but their examination suggested a possible tear or separation in my intercostals. They hurt when I try to take a deep breath. And they produce a brief stab of pain when I sneeze. Does anyone have experience with something like this? Not being able to breathe normally is affecting my running and biking pretty significantly.

    Thanks,
    Joe
  • Tom GlynnTom Glynn
    Kitma always had great advice.

    Here is what I saved:
    =============================
    My advice on care for road rashes:
    1. Clean it. Soap, water, shampoo in the shower is all fine for it. There's nothing sterile about these wounds.
    2. Maintain a moist but not wet environment. So antibiotic ointment (like Neosporin) or Silvadene (use if you don't have an allergy to sulfa drugs) to keep a moist environment. Also those products will keep the bacteria count on your wounds low. Silvadene requires a presription, BTW.
    3. Keep the wounds covered. Tegaderm is an occlusive dressing (as in, nothing gets in; nothing gets out). If your wounds have alot of drainage, it may make it too wet. Most road rash is superficial and tends to dry out so Tegaderm works most of the time. Some people are sensitive to adhesives (which Tegaderm has) and may develop a rash from it. If that is your case, then Telfa is a good non-stick dressing and wrap with either an ace (loosely) or a Kerlix. It's not an occlusive dressing so it may dry out more often and require more frequent changes. For road rash over moving parts (like knees, hips, elbows), Tubi-grip (that fish net stuff you described) works well.
    4. If you notice that the surrounding skin of the wound is becoming red, inflammed, swollen--go see your doctor and get on some antibiotics ASAP.
    5. Lastly, hydrate. You can lose alot of fluid with these wounds.
    6. One more lastly...if your dressings are stuck to your wounds, you can get in the shower, get them wet then peel them off. It will hurt alot less.

    Hope that helps. BTW, I'm a general surgeon who works in a Wound Clinic...and not just plays a doctor on TV.

    tom
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