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Road Rash Burns NOT healing after 16 days!

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Road Rash Burns NOT healing after 16 days!

Old 09-04-19, 02:06 PM
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leylou107
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Road Rash Burns NOT healing after 16 days!

Had a rough ride that ended up in a hard tumble and slide leaving rash on ribs, along thigh, elbows, and both knees. This particularly deep spot is on my lower left leg below the knee.

I've been to the ER on day 1 and they did nothing... not even clean it. Useless.

4 days later after much pain, went to Walk in clinic and they cleaned it, gave antibiotics (of which I have since finished) and 1% silver sulfadiazine cream that I've been applying daily. I pretty much clean it with soap daily in the shower, then reapply the silver stuff with a little aquaphor ointment, cover with nonstick bandage or tegaderm and self adhesive wrap. I'm on day 16 and the skin AROUND it looks better, but the actual deep open burn wound doesn't seem to be changing much or growing over.

Anyone have an open wound kinda like a deep 2nd or 3rd degree burn like this that took a LONG time to heal? What did you use and how long did it take? Don't know if I'm being impatient, but everywhere says wounds should heal in two weeks but maybe this one is just deep. I try to keep mine wet and only let it dry out after the shower, to help with skin growth and non-scabbing. Any advice or pictures of your experience would be GREATLY appreciated as I can't find any on the web anywhere! Ive got pics but it won't let me post img. yet.
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Old 09-04-19, 02:24 PM
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Years ago I took the skin off my shoulder having taken a slide through some gravel - took ~3 months for the skin around the edges to grow in and meet in the middle (was told much later that this was likely a candidate for a skin graft - there was really nothing left). Even years later, the skin on the point of my shoulder was thin and very sun-sensitive. In my limited experience, just keep it clean and be patient. Not sure why you're keeping it wet, though - I would have thought drying it out would be better - isn't scabbing over what it's supposed to do?
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Old 09-04-19, 02:37 PM
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Yes, large abrasions can take a long time to heal, and they heal from the margins inward. Unless your doctor told you otherwise, I wouldn't bother with the aquaphor; it is intended more for "minor post-operative wounds or defects," not large wounds. The silver sulfadiazine cream is bacteriocidal and will help prevent infection while the wound is open.

In the hospital where I worked, Mepilex had largely replaced Tegaderm as the preferred dressing for abrasions and open wounds, at least at the time I retired three years ago.
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Old 09-04-19, 02:37 PM
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Originally Posted by Litespud View Post
Not sure why you're keeping it wet, though - I would have thought drying it out would be better - isn't scabbing over what it's supposed to do?
Oy! Keeping an abrasion like that moist and flexible helps it heal with minimal scarring. You want the tissue underneath to regrow in a similar environment as it would have under the epidermis!

@leylou107: While the wound might be as deep as a 2nd degree (partial thickness) burn, it likely isn't entirely through your skin. The Emergency room or urgent care should have handled your care differently if you had managed to get through your dermis, because that's a significant infection risk. Trust that it's healing and follow your provider's advice. Google says it takes 27 days to replace your skin on average!

Last edited by Unca_Sam; 09-04-19 at 02:46 PM.
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Old 09-04-19, 04:05 PM
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Keep it wet!

I echo the keep it moist comment. Crash from 15 years ago looks terrible because I didnít know what to do. Good thing itís just my arm. I use it as a reminder to always wear a helmet, which saved my life on the same crash. Heal well!!
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Old 09-04-19, 05:28 PM
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Iím not going to link it because itís easy enough to search it:

Keeping a wound fully wet will heal faster and with less scar tissue.

I personally had a gash down to the bone right into my knuckle. I was afraid stitches would ruin my finger so decided to heal it myself.

I cleaned it very thoroughly once with alcohol (hurt!!!!) Then I taped it and sealed it with a bandage and then locked it in with taped plastic. I taped the edges air tight. I didnít even look at it for 3 days. Then on the evening of the 3rd day I opened it to find it had fully reattached except for one edge. I massaged the area and no puss came out, no raw smell or anything. So I cleansed it again with soap and water, put on neosporin and covered it again. I changed it daily after that. It was healed and functional in a week and a half.
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Old 09-04-19, 06:15 PM
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I can't see the photographs of the injury, but I recently had road rash that got infected and was not healing properly. I tried to heal it myself for a week, thinking it was just a graze, but it got a secondary infection from something remaining in the graze, because I didn't clean it properly. I went to the doctor who scraped a layer of gunk off the wound with a scalpel blade, packed the wound with antiseptic infused surgical gauze stuff, gave me an antibiotic injection and then put me on a course of oral antibiotics.

It was stubborn for a week or two and really didn't seem to want to heal. The doctor was quite concerned, and he mentioned the possibility of a skin graft, but thankfully after two to three weeks, everything came together really rapidly. The edges of the wound started to contract and within a week of that first really positive dressing change, the doctor was trimming the edges of the dressing and bits of the scab that had formed. A week later and the whole thing had healed, but skin was still growing back underneath the scab, so it was a few more days until the last of the scab and dressing was able to be removed.

I would strongly suggest that you see a doctor to see if you have an infection, and if so, discuss antibacterial dressings, as well as oral antibiotics.
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Old 09-04-19, 07:49 PM
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I had a bad road rash burn after being hit by a car once. You need to apply the burn cream and wrap it and leave it covered. The skin is VERY delicate, so if you wash it and reapply the cream and rewrap it every day you just need to be super duper gentle when you wash and dry it so you donít peel back the skin thatís regrowing. Consult a doctor, but it might be a good idea to disinfect it and apply the cream and wrap it for a couple days between washes so the skin has a chance to grow. You donít want to end up needing a skin graft.
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Old 09-04-19, 08:08 PM
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If the wound wasn't cleaned until day 4, you aren't on day 16, you're on day 12. Which is acceptable timeline for deep abrasions. Last ones I had weren't even that deep and were cleaned 8 hours after occurrence. Took 4-7 days to form all the scabs and the scabs over the deepest parts took almost 4 weeks before they finally fell off on their own. Mine were on my knees so I only kept them covered while I was wearing pants - 8 hours a day or so. Otherwise I left them unbandaged while I was sitting around or out riding.
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Old 09-04-19, 10:23 PM
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Originally Posted by Unca_Sam View Post
Oy! Keeping an abrasion like that moist and flexible helps it heal with minimal scarring. You want the tissue underneath to regrow in a similar environment as it would have under the epidermis!

@leylou107: While the wound might be as deep as a 2nd degree (partial thickness) burn, it likely isn't entirely through your skin. The Emergency room or urgent care should have handled your care differently if you had managed to get through your dermis, because that's a significant infection risk. Trust that it's healing and follow your provider's advice. Google says it takes 27 days to replace your skin on average!
That would explain the scarring
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Old 09-04-19, 10:49 PM
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@leylou107's album.

https://www.bikeforums.net/g/user/505396
https://www.bikeforums.net/g/album/15086400

OUCH!!!!

I'm debating whether to post the photos, but will go with your original intent.

Day 2:


https://cimg6.ibsrv.net/gimg/bikefor...3cd056567.jpeg

Day 8:


https://cimg8.ibsrv.net/gimg/bikefor...f58eb93f0.jpeg

Day 16:


https://cimg1.ibsrv.net/gimg/bikefor...613e134ef.jpeg

Last edited by unterhausen; 09-05-19 at 06:31 AM. Reason: broke image tags
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Old 09-04-19, 11:12 PM
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I've had minimal rash that healed quickly. Popped blisters & etc. With a blister, it is always best if I can keep it intact for 2 or 3 days. If it pops early, it progresses much like your wound, and seems to take forever to heal, and those are usually small.

It looks like the Day-2 photo should have healed quickly, although it does appear as if you took off a uniform outer layer of skin (whereas I think of rash as being a series of deep scratches).

A little late now, but I'm wondering how you could have prevented the back-slide from day 2. Moleskin? Lots of ointment?

Here is a discussion of "Abrasion" injury on Wikipedia., along with a series of photos for a hand abrasion, going out a month.

At first glance, your leg looks like it is getting worse. But, I'm seeing a definite pattern of follicles in the last photo (Day 16). That may be indicating that it is, in fact, healing. But, you have to protect that new layer of skin that is forming.

It is up to you as to whether you wish to continue seeing doctors.
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Old 09-04-19, 11:32 PM
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That yellow tissue looks like slough (necrotic tissue) that needs to be removed (debrided). My son had some nasty wounds from a couple of pitbulls that took months to heal. Had to go in many times to have necrotic tissue removed. The skin doesnít heal properly underneath.

edit: Above is just my barely educated opinion. You should see a doc.
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Old 09-05-19, 01:14 AM
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See a doctor immediately would be my advice. That yellowish portion of the wound is not what a healing wound should look like; for it to be healing properly, it should have formed a thick crust of a scab by now. I think that yellowish stuff needs to be removed my a medical professional and you need prescription antibiotics. That's just my opinion, but it looks like it's beyond the scope of home remedies at this stage.
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Old 09-05-19, 02:08 AM
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you are pretty much on schedule.

i longboard had more than my fair share of road rash as i was training to go faster.

that yellowing stuff in the middle is dead tissue left over from rash. just remove it in the shower. also would be a good idea to leave it uncovered if you are just staying home for the day let it dry up a little bit. if by any chance you have access to aloe vera plant cut off a leaf, peel it and put on the road rash. be warned it will smell like ****, but it does wonders in speeding up healing.

otherwise you're fine, nothing to worry about. take it from someone who has had more road rash than a sizeable chunk of the population.
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Old 09-05-19, 06:32 AM
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Moderators note: okay, let's not post the gore pictures here. We don't allow it and people can click on the links

Last edited by unterhausen; 09-05-19 at 07:16 AM.
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Old 09-05-19, 07:03 AM
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Originally Posted by unterhausen View Post
okay, let's not post the gore pictures here. We don't allow it and people can click on the links
What did you expect when you clicked on a thread titled rash w/pics? If you're squeamish you probably don't have anything to contribute. If he post links to the pics how would you be able to resist clicking?
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Old 09-05-19, 07:07 AM
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I had a nasty fall about 6 weeks ago now which resulted in a different type of wound ... much deeper and not so wide.

I went to the local clinic and had a nurse dress it for about 4 weeks, initially keeping it as a wet wound using Inadine and clearing off what slough they could with each visit then as the skin grew under letting it become a dry wound using something else but I can't remember what it was called which helped to encourage the remaining slough away.

Really would see a medical professional and let the treat it for at least a couple of weeks and until it's in a better state than it seems at the moment.

if you want the pic of my would let me me know and I can whatsapp it to you or try and work out how to get t from there onto here.
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Old 09-05-19, 07:11 AM
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Originally Posted by gregf83 View Post
What did you expect when you clicked on a thread titled rash w/pics? If you're squeamish you probably don't have anything to contribute. If he post links to the pics how would you be able to resist clicking?
Well, he's a moderator, so he's instructing people not to post gory photos. That's part of his job.

OP should be at the doctor like... now. As a person who has been injured more than enough times-- including the kinds where a nurse takes a scrub brush to it-- no abrasion should look like that after 16 days.
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Old 09-05-19, 07:12 AM
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Originally Posted by gregf83 View Post
What did you expect when you clicked on a thread titled rash w/pics? If you're squeamish you probably don't have anything to contribute. If he post links to the pics how would you be able to resist clicking?
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Old 09-05-19, 07:18 AM
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Yes, and if someone puts it in the thread title, I know that there are some image tags that need to be broken. So it's convenient that way.
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Old 09-05-19, 08:05 AM
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Originally Posted by DrIsotope View Post
OP should be at the doctor like... now. As a person who has been injured more than enough times-- including the kinds where a nurse takes a scrub brush to it-- no abrasion should look like that after 16 days.
Well that is pretty much exactly what deeper wounds look like. Some wounds take longer than 16 days to heal. Still should get the yellow stuff removed though. Deeper wounds also include black stuff (technical term - eschar) that also needs to be removed.
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Old 09-05-19, 08:16 AM
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the necrotic (dead) tissue needs to be scrapped off daily!
Soak the leg in warm water and let the necrotic tissue soften up, then use some gauze to start scrapping off the dead tissue. Then wash it up with peroxide and dress it with nonstick gauze.
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Old 09-05-19, 08:33 AM
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For my few small patches of road rash over the years I've observed that leg wounds are a lot slower to heal than upper body ones. Another issue might be that there is still debris like sand particles in the wound that the body is trying to force out.
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Old 09-05-19, 08:49 AM
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Time for maggot therapy.
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