If I didn't look like Darkman, I'd come to your office and yell at you...

October 5, 2008 10:31 AM

Thanks to a douchebag contractor that dumped a cubic yard of broken cinder blocks in the bike lane, we're back to the eternal question: Is it better to leave a large but shallow scrape injury open to the air or cover it? Or is there some other thing I should be doing?

Thus far, I've cleaned the wound vigorously with warm water and removed all the visible/palpable sand and gravel. I've also applied a thin layer of Neosporin but otherwise left the wound uncovered. Its on my forearm, if that makes a difference. So what's my best course of action, for a wound that will probably take 2-3 weeks to fully heal?

posted by Inspector.Gadget to health (9 comments total)

I asked this question a few months ago after I had already let it scab up sans bandage. This nastiness probably wouldn't have happened or been so bad if I'd put on of those stick-free bandages over it and kept it damp with antibacterial goop.

Actually, once I did start covering up, it healed pretty quickly.

So, yeah, I vote for keeping it covered for at least a few days.
posted by lunasol at 10:42 AM on October 5

Probably to wait 2-3 weeks.

How big is it, exactly? Most of the time, covering a wound is only truly useful in helping coagulation or absorbing pus. As long as you keep it clean (don't get all Lady MacBeth though), it should heal on its own just fine.

I had a similar one, covering my whole knee, that took over a month to heal. Never covered it. It's fine now.
posted by regicide is good for you at 10:47 AM on October 5

Once it's scabbed over, there's no need to cover it or make it damp. Keep it clean and dry and let your body do the rest.
posted by The White Hat at 10:53 AM on October 5

I can't answer beyond my own experience, but I am heartily convinced that continually covering the scrape with a thin membrane will minimize scarring and speed healing. Being one who is prone to such scrapes in the course of biking or otherwise, I have noticed that open-air scrape-scabs often cling to surrounding skin in such a way as to rip a deeper hole if/when they are inevitably scratched (and do they itch). Covered scrapes seem to minimize the buildup of scabs, thereby minimizing scars. I don't use any neosporin or other treatment beyond the initial cleanup. For coverage, I use IV3000 dressings because I get them for free, but similar coverings are available commerically with names like 3M Tegaderm. While these are expensive (~$1/each), they needn't be changed every day, because they are not retaining fluid or becoming dried out--they merely act as a synthetic scab-like barrier.

Good luck in your recovery... Hope the detritus gets cleaned up swiftly.
posted by zachxman at 11:23 AM on October 5

Years ago, after a skate boarding mishap the doctor wrapped my road rash in this wet anti-bacterial bandage. The idea was that the wound would heal underneath without scabbing over.

I've since used band-aids like this on smaller scrapes.

Personally I find scabs itchy, gross, and painful with the potential to leave a scar. Next time I get a scrape I'm going to give New Skin a try.
posted by wfrgms at 12:37 PM on October 5

I race bikes, and, therefore, have had more road rash than I care to remember and you care to know.

Zachxman has good advice. Tegaderm is like a miracle -- completely changed everything for me. In the old days, a crash meant weeks of pain wherever your road rash might contact clothing, nasty scabbing, potentially bad scars. Using Tegaderm, there's no scabbing, minimal pain, and stuff heals within a week instead of three with much better results on the scarring front. It's slightly expensive, but worth every penny.

Get in the shower, scrub with Betadine or something similar and really make sure it's very clean and that you have removed all the dirt and grit that you can get out of it. Then pat very dry with some sterile gauze, and put on the Tegaderm. You can leave a little tiny channel to drain fluid from the wound. Maybe wrap loosely in a gauze just for a little added padding and protection, but it's not necessary to do much more than that.
posted by dseaton at 2:09 PM on October 5

The basic first aid and EMT training I've had for abrasions calls for gently cleaning and then covering the wound with a dressing, which you change every few days.
posted by mediareport at 6:15 PM on October 5

I was in a motorcycle accident some time ago. For my severe road rash the doc used a dressing calle Xeroform with a light piece of clean gauze over it. When I ran out of the Xeroform at home he told me to use a simple wet to dry dressing. Wet a piece of gauze with sterile saline, the type you would use for contacts is fine. Apply that to the wound then put a dry piece of gauze over that and tape to hold. Change twice a day. I have very few scars from the road rash and it healed up in just a couple of weeks.
posted by Jules22871 at 8:09 PM on October 5

Healing up OK so far, going to switch to the Tegaderm tonight so I don't have to change the gauze every 8 hours or so...will let everyone know how it goes!
posted by Inspector.Gadget at 2:55 PM on October 7