Road Rash

Clad only in shorts, T-shirt, and helmet, a 21-year-old man was involved in a motorcycle accident. He sustained “road rash”-diffuse multiple body abrasions, lacerations, and contusions-particularly on the extremities. Abrasions about the chest wall and abdominal region were also noted. Other injuries included a closed right clavicle shaft fracture and a nondisplaced open fracture of the dorsal aspect of the right olecranon.

Emergent total body irrigation and debridement were performed; pulse lavage and scrub brushes were used. All wounds were dressed with bacitracin ointment, Adaptec, and 4 × 4-in gauze pads.

Postoperative wound care included bedside dressing changes for the first few days. Gradually, some of the wounds were left open to the air. An electric fan directed at the patient helped dry the wounds and ease the pain. Daily, soothing whirlpool treatments were initiated in the hospital and continued as outpatient therapy.

Dr Jack E. Cohen of Greenville, Ala, comments that he had never before seen a motorcycle accident victim with such extensive soft tissue injury and no tibial fracture. He adds that this patient recovered remarkably well; no infections developed. Physical therapy of the right elbow and right knee prevented range-of-motion loss secondary to scarring and contractures. The patient was told to apply either cocoa butter or vitamin E cream to his wounds to decrease scar formation and discoloration.