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Abrasions  The First Aid section is sponsored by SampleCo.

Scenario:  We're all familiar with abrasions. If you don't get scraped up, you aren't really mountain biking. Most biking abrasions involve knees, back of the elbows and upper forearm, and shoulders.

Description:
An abrasion is a scrape. It's caused by a rubbing injury that strips off the outer layers of skin. Large and deep abrasions are more serious. (If the injury changes shape significantly when pulling on the skin, or it fat tissue is seen, this is NOT an abrasion -- it's a full-thickness avulsion, a complete loss of all layers of the skin.)

Typical "sandstone kiss" from dropping a knee down during a four-point landing from an endo.

abras1a.jpg (10421 bytes)

Concerns:
Any deep abrasion will leave some scar tissue behind. On the face, scars are unsightly. Over joints, a bad scar may prevent full motion. Proper treatment will minimize the scar, making it less noticeable and reducing stiffness. An abrasion is often contaminated with dirt, gravel, and other foreign material. Infection is a risk, especially with deep, crushed, or dirty abrasions. In some severe abrasions, the skin will die -- leaving the equivalent of a third-degree burn.

See the doctor if:
    there is mushy tissue exposed that changes shape easily
    the scrape is extremely dirty or won't come clean
    the scrape is very large
    the scrape is on a critical area: face, genitals, hands

An abrasion should hold its shape when the skin is moved or stretched. If any part of the wound gapes or changes shape, this is a more serious injury.

This abrasion, caused by a high-speed touchdown on the back of the forearm, has a gouge in the center that exposes fat. This injury should be treated by your doctor.

lac3.jpg (14077 bytes)

abras1b.jpg (13492 bytes) Immediate care:
Relieve pain with an anesthetic spray or pain relieving gel. Wash the scrape thoroughly. If necessary, soak in the tub. The quicker you start scrubbing the abrasion, the less it will hurt. Be aggressive. Deep dirt can be cleaned out with a sterile toothbrush (a newly-purchased brush taken directly from its container).

Agressive cleaning decreases infection risk, and lets you check for deeper damage.

During the cleaning, look closely for punctures within the scraped area. If there is ANY hole in the skin, no matter how tiny, see the doctor. You may have a small rock underneath that hole.

After the initial washing, scrub with povidone-iodine (sample brand Betadine) on a gauze pad, a benzalkonium chloride cleansing pad (sample brand Bactine), or another antiseptic on a gauze pad. If you can't get the abrasion clean, go see the doctor.

Young or tenderhearted bikers may need help cleaning the scrape properly.

abras1c.jpg (14416 bytes)

abras1d.jpg (9566 bytes) Apply antibiotic ointment to the abrasion. To prevent sticking of the bandage, use plenty of ointment for this first dressing.

Bandage the abrasion. Usually, a non-stick pad, then gauze, then a kling wrap protects a larger scrape well. Secure the dressing with a self-adherant wrap, such as Coban.

Polysporin or Neosporin are example brand names of antibiotic ointments that help abrasions heal faster.

Supplies for abrasion treatment:
     Antiseptic cleansing pad or towel
     Antibiotic ointment
     Non-stick pad
     Gauze padding
     Roll gauze
     Self-adherant wrap
First aid kits, and individual first aid supplies, are available from the sponsor of the First Aid section, SampleCo.

Ongoing care:
Change the dressing daily. If the bandage sticks, soak it in warm water with a drop of soap. Dilute hydrogen peroxide can help soften a thickly crusted bandage. The scrape will heal much more quickly if it's bandaged for the first few days.

kneeabr2.jpg (6865 bytes)

kneeabr1.jpg (9309 bytes) Most bikers prefer to let the wounds dry (and remain uncovered) after 3 to 5 days of bandaging. Depending on the depth of the abrasion, healing can take from 1 week to 4 weeks.

Four-day old abrasion is now painfree to touch and dry. At this point, it's reasonable to let the scape stay open, even though healing is faster if dressings are continued.

Watch for:
See the doctor if there is redness around the wound, red streaks, swelling, drainage, fever, tender bumps in the groin or armpit upsteam from the wound, or an unexplained increase in pain or tenderness. See section on infection.

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