| Major Wound Dressing |
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your on-line source for first aid supplies such as non-stick pads,
gauze, and wrapping. See the shopping links below. |
First, carefully inspect the injury. If there are punctures that penetrate into the
fat, consider the possibility that there is gravel under the skin.
Check the stability of
any areas of deeper skin injury by stretching the edges. Decide whether this will be a
permanent dressing, or just a temporary patch until you get to the doctor.
| Initial cleaning: Wash the wound thoroughly. Most
likely, the only source of water will be your water bottle. In this case, you may need to
be conservative with the water: squirt, scrub, squirt again, scrub again.
If you don't have complete dressing materials with you, or if you can't get the wound
clean, plan on re-cleaning and dressing the wound after you return to civilization. |
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Scrub the wound until the dirt is removed. In sliding, bouncing abrasions,
the dirt is harder to remove and may require aggressive scrubbing. If you plan to care for
the wound at home, you must get the wound completely clean. It's easiest to scrub
immediately after the injury. A couple of hours later, the wound will be more sensitive.
If you need a "scrub brush," the seam of your biking shirt
sleeve can help
remove stubborn dirt. A benzalkonium chloride towelette is a good antiseptic cleaning
tool. Wrinkle it up, so the edges can remove dirt. |
If you're on a short ride and the wound isn't bleeding, you could defer thorough
cleaning until you're in the shower. A few minutes in the water will soften up the blood
and dirt. The warm water tends to numb up abrasions and lacerations, so they're easier to
clean. Then take a rough washcloth and scrub the hell out of those scrapes. They need to
be pink -- no brown dirt color remaining!
| Apply antibiotic ointment (if you have it). Neosporin is a sample brand.
Smear a thick coating of the antibiotic liberally over the entire wound area. The
antibiotic ointment protects the wound from dryness. It helps keep the bandage from
sticking to your wound. And of course, it kills germs to reduce the infection risk.
Even if the bandage is only temporary, the antibiotic ointment can help dissolve road
tar and soften any remaining dirt, so it will be easier to clean later. |
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Creating the dressing: Place a non-stick pad over
the wound. It should be large enough that it can slide or shift a bit without uncovering
the wound. Telfa and Adaptic are sample brands.
If additional padding is needed, put gauze pads over the non-stick pad to provide
thickness, or use a padded roll gauze (sample brand Kerlix) to cushion the area.
Click
here to link to WoundCareShop to purchase first
aid supplies such as non-stick pads. |
| Secure the dressing with a kling roll gauze. Extend the gauze an inch or
two beyond the borders of the dressing. The wrap should be snug but not tight. As you
wrap, vary the angle of application so that not all passes are perfectly circular -- angle
the wrap so it crosses the wound at a 30 degree angle one direction then straightens as it
wraps around, then wrap around again in a full straight circle, come back the other
direction at 30 degrees and straighten as you wrap around, make another straight circle,
etc. |
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If the injury is over an area that will move, such as the elbow or knee, apply the
gauze while the joint is half-way bent (about 45 degrees off of straight). To keep the
dressing from creeping as the joint is moved, be sure to wrap the full width of the roll
gauze circularly above the joint and below the joint.
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Secure the kling roll gauze with a self-adhering elastic (sample brand
Coban) wrap. Extend the borders of the elastic wrap a couple of inches beyond the kling
wrap. If you don't have Coban, a standard elastic wrap ("Ace") will do, although
it tends to migrate around a lot more. Tape can be used to hold the dressing, but
doesn't provide dust and moisture protection like Coban. And it tends to pull loose as you
continue biking. I almost never use any tape in dressings, because it just doesn't work. Click
here to link to WoundCareShop to purchase first
aid supplies such as KLING or Coban wrap. |
| After finishing the Coban wrap, you're ready to continue biking. If
you're not absolutely certain the wound is clean, it will need a "re-do" when
you get back. Decide whether you're heading for the doctor, or taking care of the wound
yourself.
If you're planning home-care of a wound that remains dirty, hit the shower. Scrub the
wound mercilessly with an abrasive sponge or washcloth. Expect to make it bleed again, but
be sure you've gotten it clean. Then redress it with fresh material. |
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Helpful hint: EMT snips can be used to custom-cut gauze
pads to a shape that makes efficient and comfortable dressings. |
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