Treating Road Rash

The 2016 Olympic women’s and men’s road races were completed in Rio this past weekend.  It turned out to be a grueling race with several riders crashing on the descent of the final climb.

Assessing the Severity of Road Rash
Falling onto the pavement at high speeds is obviously a traumatic experience for both professional and novice riders alike.  After ensuring there are no severe injuries or broken bones, the next thing to evaluate is the severity of skin damage or road rash.  The level of skin injury can be classified into three degrees.

First Degree – Only the outer layer of skin (epidermis) is affected.  The skin will appear red but typically will not require extensive treatment.
Second Degree – The outer and portions of the inner layer (dermis) are affected.  The skin will appear discolored and moist.  Medical attention is required if the bleeding won’t stop, if there is a deep cut that requires stitches, or if any debris remains deeply embedded within the skin.
Third Degree – This is the most severe and affects all layers of the skin.  The loss of skin reveals underlying fat and connective tissue.  This level of injury requires immediate medical attention and may require a skin graft to heal properly.
Cleaning Road Rash
Road rash should be cleaned as quickly and thoroughly as possible to prevent infection.  This can be accomplished with a large amount of water or with a saline wound wash under moderate pressure.  Mild antibacterial soap may be used, but avoid hydrogen peroxide or rubbing alcohol as they may harm the skin and delay the healing process.  Use a clean washcloth or gauze to gently remove any dirt or debris.  Do not scrub vigorously as this may further damage the skin.  Once the wound has been cleaned and dried, it needs to be properly dressed.  Many over the counter wound care products are available.

Dressing Road Rash with Ointment and Bandages
A traditional dressing is comprised of a thin layer of antibiotic ointment (Neosporin or Bacitracin) with a nonstick gauze pad (Telfa).  This may be applied and changed at least once a day for one week or until a scab forms.  To avoid scarring, avoid prematurely removing any scabs.

Dressings that promote a moist environment improve the rate of healing and avoid the formation of a scab.  A semipermeable dressing (Tegaderm or Opsite) or a hydrocolloid dressing (DuoDerm) may be placed directly onto the wound without any ointment necessary.  These dressings may be changed every couple days depending on how much the wound drains.

Monitor Healing
During the healing process, inspect the wound daily.  Once the skin heals, use sunscreen and keep the area covered for at least a month.  New skin is sensitive to the sun and may permanently darken.

When your skin meets the road, a thin layer of clothing offers little protection and some damage to your skin is unavoidable.  Proper treatment of road rash will prevent infections and repair the skin allowing you to get back on the bike faster.  If your skin does not appear to be healing properly or if you have any concerns, consult your doctor.