road rash and fancy dressings



I lost a reasonable amount of skin over a week ago, and have spent the
last week experimenting with various dressings. My 3-point
landing-and-roll scraped the skin off my knee, above my hip, the ball
of my hand, my elbow, and my shoulder.

The problem I'm having is that none of the generally suggested
dressings seem to last more than a few hours before starting to peel
off, and eventually falling off altogether. As they're supposed to seal
out dirt and moisture, this is problematic. I've tried Spenco 2nd Skin,
3M Tegaderm, and J&J Advanced Healing Adhesive Pads.

All three work fine as long as I don't move, but once I walk around
much or go for a ride, they start to work loose. The lone exception is
my shoulder, which has had a single J&J Healing Pad for 3 days now.
Tegaderm was nearly successful on my knee, but after a long ride on
Saturday that too pretty much fell off.

What's the best way to apply these dressings on joints to ensure they
don't work loose during physical activity? Buying replacement dressings
is sending me to the poorhouse.

Thanks,
Sam
 
[email protected] wrote:
> I lost a reasonable amount of skin over a week ago, and have spent the
> last week experimenting with various dressings. My 3-point
> landing-and-roll scraped the skin off my knee, above my hip, the ball
> of my hand, my elbow, and my shoulder.
>
> The problem I'm having is that none of the generally suggested
> dressings seem to last more than a few hours before starting to peel
> off, and eventually falling off altogether. As they're supposed to seal
> out dirt and moisture, this is problematic. I've tried Spenco 2nd Skin,
> 3M Tegaderm, and J&J Advanced Healing Adhesive Pads.
>
> All three work fine as long as I don't move, but once I walk around
> much or go for a ride, they start to work loose. The lone exception is
> my shoulder, which has had a single J&J Healing Pad for 3 days now.
> Tegaderm was nearly successful on my knee, but after a long ride on
> Saturday that too pretty much fell off.
>
> What's the best way to apply these dressings on joints to ensure they
> don't work loose during physical activity? Buying replacement dressings
> is sending me to the poorhouse.


Surgitube tubular gauze. I only wear dressings for a few days and then
let the wound air dry with a little Neosporin. Note, I am not a
doctor. -- Jay Beattie.
 
[email protected] wrote:
> I lost a reasonable amount of skin over a week ago, and have spent the
> last week experimenting with various dressings. My 3-point
> landing-and-roll scraped the skin off my knee, above my hip, the ball
> of my hand, my elbow, and my shoulder.
>
> The problem I'm having is that none of the generally suggested
> dressings seem to last more than a few hours before starting to peel
> off, and eventually falling off altogether. As they're supposed to seal
> out dirt and moisture, this is problematic. I've tried Spenco 2nd Skin,
> 3M Tegaderm, and J&J Advanced Healing Adhesive Pads.


> All three work fine as long as I don't move, but once I walk around
> much or go for a ride, they start to work loose. The lone exception is
> my shoulder, which has had a single J&J Healing Pad for 3 days now.


3 days? I'd shoot for changing that bandage every day. That'd be good
wound hygeine. If you're working out while healing, you need an elastic
wrap in conjunction with adhesive to keep everything in place. Jay
Beattie had a good solution with the tubular gauze. 3 days? eee-eeeeww.

> Tegaderm was nearly successful on my knee, but after a long ride on
> Saturday that too pretty much fell off.
>
> What's the best way to apply these dressings on joints to ensure they
> don't work loose during physical activity? Buying replacement dressings
> is sending me to the poorhouse.


You could also take Jay's advice on dry healing. It's not as good in
terms of healing time or scarring, but it isn't sticky. It does like to
crack and bleed though.

>
> Thanks,
> Sam
>


Robin Hubert
 
In article <[email protected]>, Jay Beattie wrote:
>
> [email protected] wrote:
> > I lost a reasonable amount of skin over a week ago, and have spent the
> > last week experimenting with various dressings. My 3-point
> > landing-and-roll scraped the skin off my knee, above my hip, the ball
> > of my hand, my elbow, and my shoulder.


Well... On a big area it is difficult to get good enought proctection.
I have used electric tape (flexible PVC and has a good glueing if applied dry, and holds out in
the wet weather for several hours)
Maybe it is not so kind to the skin, but I have never had any problems, especially
after three hours.

I tried with wetproof plaster before, but it worked poorly. I applied electric tape
around, to seal the ends and it helped. Still, I am not satificed...

Now, as I have a cut (four stings!) in my finger, and I am still bicycling in the
rain, and I use a plastic bag and tape it around the finger with electric
tape. Works great. Flexible enought and reliable, but I have to remove it in three or
four hours to avoid building up too much moisture in the wound.

But - keep the wound clean, it is very important when you are active and out
in wet weather!

--
 
On 23 May 2006 19:47:09 -0700, [email protected] wrote:

>I lost a reasonable amount of skin over a week ago, and have spent the
>last week experimenting with various dressings. My 3-point
>landing-and-roll scraped the skin off my knee, above my hip, the ball
>of my hand, my elbow, and my shoulder.
>
>The problem I'm having is that none of the generally suggested
>dressings seem to last more than a few hours before starting to peel
>off, and eventually falling off altogether. As they're supposed to seal
>out dirt and moisture, this is problematic. I've tried Spenco 2nd Skin,
>3M Tegaderm, and J&J Advanced Healing Adhesive Pads.
>
>All three work fine as long as I don't move, but once I walk around
>much or go for a ride, they start to work loose. The lone exception is
>my shoulder, which has had a single J&J Healing Pad for 3 days now.
>Tegaderm was nearly successful on my knee, but after a long ride on
>Saturday that too pretty much fell off.
>
>What's the best way to apply these dressings on joints to ensure they
>don't work loose during physical activity? Buying replacement dressings
>is sending me to the poorhouse.


Use some sort of tape around the edges to hold them on, and make sure
the tape bonds well to your skin. I think that'll work best if the
skin has no hair, is very clean, and is then treated with tincture of
benzoine, or at least rubbing alcohol, to make it very dry. But have
an "exit port" for any liquid that builds up under the bandage -- that
is use a thin streak of vaseline or something like that to make a spot
where the tape does not bond to your skin, at the lowermost spot on
the bandage, to allow some drainage.

I don't have experience with a bandage over my knee, but I've kept
Tegaderm on for several days, through several showers, using this
method.

JT

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John Forrest Tomlinson wrote:
> On 23 May 2006 19:47:09 -0700, [email protected] wrote:
>
> >I lost a reasonable amount of skin over a week ago, and have spent the
> >last week experimenting with various dressings. My 3-point
> >landing-and-roll scraped the skin off my knee, above my hip, the ball
> >of my hand, my elbow, and my shoulder.
> >
> >The problem I'm having is that none of the generally suggested
> >dressings seem to last more than a few hours before starting to peel
> >off, and eventually falling off altogether. As they're supposed to seal
> >out dirt and moisture, this is problematic. I've tried Spenco 2nd Skin,
> >3M Tegaderm, and J&J Advanced Healing Adhesive Pads.
> >
> >All three work fine as long as I don't move, but once I walk around
> >much or go for a ride, they start to work loose. The lone exception is
> >my shoulder, which has had a single J&J Healing Pad for 3 days now.
> >Tegaderm was nearly successful on my knee, but after a long ride on
> >Saturday that too pretty much fell off.
> >
> >What's the best way to apply these dressings on joints to ensure they
> >don't work loose during physical activity? Buying replacement dressings
> >is sending me to the poorhouse.

>
> Use some sort of tape around the edges to hold them on, and make sure
> the tape bonds well to your skin. I think that'll work best if the
> skin has no hair, is very clean, and is then treated with tincture of
> benzoine, or at least rubbing alcohol, to make it very dry. But have
> an "exit port" for any liquid that builds up under the bandage -- that
> is use a thin streak of vaseline or something like that to make a spot
> where the tape does not bond to your skin, at the lowermost spot on
> the bandage, to allow some drainage.


Yeah, making sure there is no hair really helps. When I've had road
rash on a forearm, I always shave the wound before dressing. I
scrub-clean the area, put in a new blade, and shave just like I would
shave a leg, then rinse and scrub-clean again. It gets the hair out of
the wound and keeps it from complicating things. By the time stubble
starts to appear, you've got a good head-start on healing.

You would think it hurts, but it actually doesn't hurt any more than
the wound just sitting there untouched. It's important that you get a
good soaking and scrubbing if too much healing has started before you
shave.

-Mike
 
<[email protected]> wrote in message news:[email protected]...
>I lost a reasonable amount of skin over a week ago, and have spent the
> last week experimenting with various dressings. My 3-point
> landing-and-roll scraped the skin off my knee, above my hip, the ball
> of my hand, my elbow, and my shoulder.
>
> The problem I'm having is that none of the generally suggested
> dressings seem to last more than a few hours before starting to peel
> off, and eventually falling off altogether. As they're supposed to seal
> out dirt and moisture, this is problematic. I've tried Spenco 2nd Skin,
> 3M Tegaderm, and J&J Advanced Healing Adhesive Pads.
>
> All three work fine as long as I don't move, but once I walk around
> much or go for a ride, they start to work loose. The lone exception is
> my shoulder, which has had a single J&J Healing Pad for 3 days now.
> Tegaderm was nearly successful on my knee, but after a long ride on
> Saturday that too pretty much fell off.
>
> What's the best way to apply these dressings on joints to ensure they
> don't work loose during physical activity? Buying replacement dressings
> is sending me to the poorhouse.
>
> Thanks,
> Sam
>


The link provides the best information on dealing with road rash that I have read. The Duoderm bandages work really well.

http://www.velonews.com/train/articles/3909.0.html
 
Robin Hubert wrote:
> [email protected] wrote:
> > I lost a reasonable amount of skin over a week ago, and have spent the
> > last week experimenting with various dressings. My 3-point
> > landing-and-roll scraped the skin off my knee, above my hip, the ball
> > of my hand, my elbow, and my shoulder.
> >
> > The problem I'm having is that none of the generally suggested
> > dressings seem to last more than a few hours before starting to peel
> > off, and eventually falling off altogether. As they're supposed to seal
> > out dirt and moisture, this is problematic. I've tried Spenco 2nd Skin,
> > 3M Tegaderm, and J&J Advanced Healing Adhesive Pads.

>
> > All three work fine as long as I don't move, but once I walk around
> > much or go for a ride, they start to work loose. The lone exception is
> > my shoulder, which has had a single J&J Healing Pad for 3 days now.

>
> 3 days? I'd shoot for changing that bandage every day. That'd be good
> wound hygeine. If you're working out while healing, you need an elastic
> wrap in conjunction with adhesive to keep everything in place. Jay
> Beattie had a good solution with the tubular gauze. 3 days? eee-eeeeww.
>
> > Tegaderm was nearly successful on my knee, but after a long ride on
> > Saturday that too pretty much fell off.
> >
> > What's the best way to apply these dressings on joints to ensure they
> > don't work loose during physical activity? Buying replacement dressings
> > is sending me to the poorhouse.

>
> You could also take Jay's advice on dry healing. It's not as good in
> terms of healing time or scarring, but it isn't sticky. It does like to
> crack and bleed though.


Yah, my approach is for first degree road rash, and even when
uncovered, I use an antibiotic cream until it is healed up. For deeper
wounds, I keep it covered much longer -- and for joints, I use a mesh
stocking to hold the dressing in place. Here is another link for wound
care, and it advocates keeping everything covered for weeks -- which is
longer than my wound attention span. http://tinyurl.com/ja3qs

Many years ago, I crashed coming down a descent in the Santa Cruz
mountains and managed to wipe out both sides of my body. My girlfriend
at the time was in to natural stuff, and she taped sliced-open aloe
vera leaves to my shoulders and hips. I mean, really, what could I
say? Are you stoned? I looked like a salad. Anyway, those things hurt
when they dry out. Don't do that. Oh, the things we do for love. --
Jay Beattie.
 
Dressings can be held in place with elastic tape such as
Elastikon or Elastoplast. The tape is non-sterile and not intended for
wound care, but can be used over a material that is. These tapes
stretch only lengthwise, so they should be oriented according to the
direction of flex at the wound area. They stick well, but can adhere
better if you apply some contact cement to skin and any part of the
dressing that doesn't need to breath. Dry the cement with a blow dryer
and then apply the tape over it. (Close the cement can before you turn
on the dryer; the fumes are quite flammable.)

Admittedly, this is a bit of a chore, but it works really
well. For the past week I've been riding with a deep cut on my thumb
right where I hit the shifter. My dressing has held even during 50-60
mile rides in the rain. Since it takes so long to craft the bandage, I
leave it on for 2 days, which hasn't caused any problems. (There's
some triple antibiotic ointment in there.) In the future, I've
resolved to be more careful with scissors. Damn, those Fiskars are
sharp!





You got to be very careful if you don't know where you're going, because you might not get there.


- Yogi Berra
 
Thanks all for the advice, to respond to a couple comments:

Regarding changing the dressings more frequently, these particular
dressings are allegedly designed to stay on for a longer period than a
traditional neosporin-and-gauze treatment. They are marketed as
appropriate for burns, and most 'road rash' webpages recommend leaving
them on for up to a week, allowing them to form an artificial scab.

In hindsight, the J&J pad on my shoulder was probably on for about 5
days (longer than the 3 days I guesstimated). I took it off this
morning, and my shoulder is almost completely healed (just a bit pink)
with no scab. On the other hand, a gash on my forearm which I treated
with occasional neosporin and a bandaid is completely scabbed over.

Thanks for the tubular gauze suggestion; I'll pick some up for next
time. It does seem like some areas (like my hand) will still be tricky
to use with that; even with the hand completely wrapped in gauze, the
pads I used still lost their adhesion and started to float around under
the gauze.

Tape: I've been using the cloth tape (that is designed for gauze, I
guess). It seems to stick reasonably well to shaved skin but doesn't
flex at all which severely limits joint movement. It sounds like I
should try one of the elastic tapes mentioned.

Thanks,
Sam
 
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In article <[email protected]>,
<[email protected]> wrote:
>Thanks all for the advice, to respond to a couple comments:
>
>Regarding changing the dressings more frequently, these particular
>dressings are allegedly designed to stay on for a longer period than a
>traditional neosporin-and-gauze treatment. They are marketed as
>appropriate for burns, and most 'road rash' webpages recommend leaving
>them on for up to a week, allowing them to form an artificial scab.
>


_ I found that I had to change them more often than that after my
last crash. About once a day, the fluid would accumalate and
compromise the seal of the bandage at least for the first couple
days. I could have problably left them on longer, but I was
paranoid about infection. There are kinds that come with some
sort of absorbant pad that seemed to last a bit longer. Even
with the added expense I thought it was well worth it in that
the wounds were largely healed after one week. That's much much
faster than my previous experiences with the dry healing methods.

_ If you have a large rash, use multiple tegaderms to cover the
area, you want a good seal on healthy skin beyond the wound.

_ Booker C. Bense

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[email protected] wrote:
> I lost a reasonable amount of skin over a week ago, and have spent the
> last week experimenting with various dressings. My 3-point
> landing-and-roll scraped the skin off my knee, above my hip, the ball
> of my hand, my elbow, and my shoulder.
>
>
> All three work fine as long as I don't move, but once I walk around
> much or go for a ride, they start to work loose. The lone exception is
> my shoulder, which has had a single J&J Healing Pad for 3 days now.
> Tegaderm was nearly successful on my knee, but after a long ride on
> Saturday that too pretty much fell off.


I have best luck with Tegaderm. They can come loose in the shower,
which I think is just too much water. Perhaps you sweated one off?

> What's the best way to apply these dressings on joints to ensure they
> don't work loose during physical activity? Buying replacement dressings
> is sending me to the poorhouse.


How I've done it in four short steps:

(1) Wash the wound well, and dry it, before applying a dressing. (IOW,
take a shower first.)

(2) Apply antibiotic ointment ONLY to the wound itself. Don't smear it
all over the place. Keep the greasy Neosporin (or similar) off the part
of your skin where the sticky part of the dressing will go. It may be
worth eyeballing the dressing to figure out how much you can cover --
IME, it's better to leave an extra 1/4" without goo than put it on too much.

(3) Flex the joint at least partially. It's sort of like the fine art
of applying a Band-Aid -- you need to figure out how far to bend the
knee or elbow so the Band-Aid or Tegaderm will flex up enough, but not
too much, when you straighten the joint.

(4) Keep an eye on it. If you see the adhesive start to come up, add
tape to the top of the dressing (let the bottom slide). If it starts to
get infected (now we're talking milky green, not clear), you'll need to
remove the dressing, wash well, and re-bandage.

Of course, take all this with a hefty dose of YMMV. The road rash I've
treated this way usually skins over, pink, in 3-5 days, when I'd expect
it to take 10 days to 2 weeks with gauze (based on experience, alas).
And I've only caught an incipient infection once. Some people aren't
that lucky.

Pat
 
On 24 May 2006 10:14:47 -0700, [email protected] wrote:


>In hindsight, the J&J pad on my shoulder was probably on for about 5
>days (longer than the 3 days I guesstimated). I took it off this
>morning, and my shoulder is almost completely healed (just a bit pink)
>with no scab.


That's what's supposed to happen.

JT

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On Wed, 24 May 2006 17:43:36 +0000 (UTC), Booker C. Bense
<[email protected]> wrote:

>-----BEGIN PGP SIGNED MESSAGE-----
>
>In article <[email protected]>,
> <[email protected]> wrote:
>>Thanks all for the advice, to respond to a couple comments:
>>
>>Regarding changing the dressings more frequently, these particular
>>dressings are allegedly designed to stay on for a longer period than a
>>traditional neosporin-and-gauze treatment. They are marketed as
>>appropriate for burns, and most 'road rash' webpages recommend leaving
>>them on for up to a week, allowing them to form an artificial scab.
>>

>
>_ I found that I had to change them more often than that after my
>last crash. About once a day, the fluid would accumalate and
>compromise the seal of the bandage at least for the first couple
>days.


You could try leaving an opening at the bottom of the bandage to allow
drainage -- just 1cm across, with a gap in the tape.

JT

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