I am not sure I buy into the school of thought that you are not a real cyclist until you crash, but I guess I am a real cyclist now. On Easter, I crashed coming down Mt. Tamalpais–I slid out and went down hard descending around a bend. Hard enough to warrant a trip to the ER to see if anything was broken (thankfully no) and if I needed stitches (yes and no–more on that later).
There are numerous opinions on how best to treat road rash–wet/dry/covered/uncovered–but this is the routine I followed based on the advice I was given by the ER doctor. This is by no means meant to replace proper medical advice. If your road rash is bad enough, you hit your head or hurt your back/neck, by all means get yourself to the doctor.
1. Clean the wound when you get home. Depending on how bad it is, soap and water should do just fine. Tony at Bicycle Odyssey swears by First Defense cleansing antiseptic spray. My cuts were deep enough I had the hospital clean them out (that hurt like a bugger). The main premise of road rash care is to keep the wound clean so that it doesn’t get infected–you will want to clean it with soap and water pretty much every day. I also dabbed my road rash with Betadine Solutionafter I got out of the shower to help kill any germs that might remain.
To stitch or not to stitch–I had gashes deep enough they definitely needed sutures but the ER doc said he has learned not to mess with “thousands of years of evolution” and instead leave the wounds open so my body can clean out any gunk driven deep inside. He has stitched road rash before and almost all ended up infected.
2. I went the wet/covered route to help cut down on scaring. For the first ten days or so, I coated a non-stick gauze pad with antibiotic cream, placed it over the wound, and covered with self-adherent wrap.The self-adherent wrap was the only thing I could get to stay on my arm. Cotton gauze just slid off. I changed the dressing every day after my shower and Betadine routine.
3. When the major chunks missing from my arm had mostly filled in, I switched to Tegadermpatches. Used as post surgical dressings, these are like a second skin that keep water and germs out but continue to let the wound breathe. They last for up to a few days at a time, depending on how much exercise you do, etc. Duoderm is another brand of the same type of dressing but harder to find. I used the Tegaderm patches for about another week. If you have mild road rash, you could jump straight to using these wonder patches–they really do seem to help you heal faster.
4. Once you are mostly healed and it’s just new pink skin left, make sure you keep it out of the sun if you don’t want scaring down the line.
It’s been almost three weeks now and my road rash is still not fully healed but getting close. I think it’s the fear of crashing again that is going to take the most time to get over. I was back on the bike about three days after the crash but have taken it easy.