by Buck Tilton ( cofounder of the Wilderness Institute)

It is important for the outdoor enthusiast to carry the knowledge and material for treating "road rash" for several reasons. One is they hurt, and proper treatment reduces pain, eventually. Another is that untreated abrasions leave more noticeable scars. A third reason is to prevent infection, and few wounds are more prone to infection than an abrasion.

The time it takes to properly treat an abrasion is directly proportional to the size and strength of the victim. Wimpy people can be held down while they are being vocally abusive as their wounds are thoroughly cleaned and bandaged. With large, powerful patients, you'll want to get in and get out fast.

Treatment:

• Irrigate the wound to remove loose foreign material. Water will do fine, and any water safe to drink is safe to clean wounds. This is best done with an irrigation syringe, a device that comes in most first aid kits. Or fill a plastic bag with water and punch a pinhole in it. The idea is to create a forceful stream to wash out dirt and debris. In the process, you may, also, be washing out some of the germs.


• Vigorously scrub the abrasion. Some first aid kits have cleansing pads especially made for abrasions and containing a topical anesthetic. Cleansing pads allow you to wipe the abrasion gently first, and wait about five minutes for the anesthetic to work. Warning: the scrubbing is still quite painful, but absolutely necessary for safeguarding against infection and tattooing (a unique form of scarring left by embedded material). You can scrub with any clean cloth and any soap. Scrub until nothing remains visible in the wound except raw meat.


• Rinse the wound again. If the scrubbing has started some bleeding, you can just let it bleed or apply pressure with a sterile gauze pad or sponge. Letting it bleed might be a bit better since the patient is doing a little involuntary self-cleaning of the wound.


• When you have a clean, non-bleeding wound, apply a thin layer of antibiotic ointment (not cream, but ointment).


• Dress and bandage the wound. Dressings go directly on the abrasion, and any non-adherent dressing will work. Spenco 2nd Skin works really well, soothing with its coolness, protecting with its rubbery-ness, allowing you to see through to watch the wound for signs of infection. It can be left in place as long as no infection shows up. Over the dressing goes the bandage. You can tape a gauze pad over the dressing, but elastic wraps work better, being more secure. Stretch gauze is probably the best: it conforms easily to the shape of the abraded body part, it is lightweight, it is more difficult to put it on too tight (which can cut off healthy blood flow).

Human skin is tough and resilient, fortunately, and abrasions, with a little pre-planning, are easy to manage.

We're lucky that way . . . er, I mean, it could be worse!

© 1999 Buck Tilton. All Rights Reserved.