Sooner or later, all triathletes hit the deck, and the result, more often than not, is road rash. Thankfully, such abrasions usually require only basic care, but it must be the right care. Dr Helen Iams has worked as Medical Director for races such as the US Pro Criterium Championships. "Pro riders give me lots of practice with road rash," she says. Here's her prescription for fast healing.
Before sizing up skin loss, check for other injuries. "I've had riders come into the medical tent with cracked-open helmets, but no idea they had hit their head," says Iams. If you're with a group and the injured rider has slow or slurred speech, call for medical assistance. If you're riding solo, carry a mobile phone. And if you're wondering how to evaluate the seriousness of a gash, Iams has a rule: if you can't stop the bleeding by applying pressure for 15 minutes, you need stitches.
After a crash, you may be tempted to douse your wound with water from your drinks bottle to clean it up. "That's not a bad idea to get rid of any dirt," says Iams, "but the bacteria on the bottle valve are bad." Antiseptic wipes are a much better bet, she says.
Get the grit out
Wash the rash as soon as you get home. To clean it well, says Iams, you should begin with painkillers. She recommends blanketing the wound with 10 x 10cm gauze pads saturated with antiseptic wash. "I let the wash soak in for a few minutes until the nerves are numbed," she says. Then she gently wipes the grime from the scrape using soap and water. "You need to get all the grit, bits of asphalt, everything," she says. "That stuff can have bacteria behind it." Stay clear of iodine, alcohol and hydrogen peroxide.
"They damage skin cells. The less damage there is to the skin, the faster it heals." For stubborn, sticky contaminants such as road tar, Iams recommends baby oil. "It will dissolve the tar, and you won't need to scrub."
Let the healing begin
After you wash the area, cover the abrasion to keep it clean and moist. Iams applies bacitracin, which kills bacteria and prevents the wound from drying or sticking to the bandage. Then she uses generic nonstick, gauze-type bandages, secured with silk tape. "I use cheap dressings until the oozing stops, maybe for a few days," she says. Then it's time for advanced hydrocolloid bandages - precious items for road-rash victims. "Put them on, and just leave them for a week until they fall off," she says. "They keep bacteria out, but let water come through and evaporate." Iams's other days- after tips include icing the injured area to reduce swelling, and hotfooting it to your doctor if you think the wound requires a second opinion.