skin graft or bandage? (warning: wound image enclosed)

[jules21]

spent most of last night in casualty waiting to have this checked out. the doctor sent me there, reckons it may need a graft. the hospital couldn't decide so i have to go back next week to see the plastic surgeon. reckon i might ask for my eyelids to be lifted slightly while i'm there.

[twizzle]

Amputate.



So... what's the story? Drunk riding? Superman leap off the bike?

[trailgumby]

Bandage. You want them to cut skin off somewhere else? Then you'l have two areas to heal and two scars instead of one.

[wizardhat]

Bandage! If you're anything like me you'll get some scarring that will fade over time (I did something similar to my knee while skateboarding a while ago).

[Oxford]

not to sound to Monty Python and unsympathetic, but is it really that serious? just looks like a bit of gravel rash. I've had far larger areas, with deeper wounds heal up fine. use a good antiseptic to clean it or even just warm soapy water. I use a hog bristle brush to brush out wounds like this, then an antiseptic cream and cover with a self adhesive wound pad. leave for a week then change dressing (clean if necessary). rinse and repeat until it is healed.

[A_P]

when you go back, ask for a silver foam dressing like mepilex Ag ( you wouldnt want to by theses a the chemist) and leave it there for a week.

[jules21]

So... what's the story? Drunk riding? Superman leap off the bike?

my rear tyre disintegrated mid-corner in a crit on Wednesday. pretty embarassing as there was still a reasonable amount of tread left, but on closer inspection the rubber seems to have perished a bit. it was torn apart during the crit and spat me off

not to sound to Monty Python and unsympathetic, but is it really that serious? just looks like a bit of gravel rash. I've had far larger areas, with deeper wounds heal up fine.

yes, it's just a flesh wound

i thought the same but apparently the medicos are worried there may be too little flesh/fat in that small area in the middle for the skin to grow back.

Bandage. You want them to cut skin off somewhere else? Then you'l have two areas to heal and two scars instead of one.

i'd prefer a bandage too, but i'll wait and see what the plastic surgeon says next week.

when you go back, ask for a silver foam dressing like mepilex Ag ( you wouldnt want to by theses a the chemist) and leave it there for a week.

i might give that a go, ta.

[cp123]

That will heal well with plastic skin like tegaderm or one of those types of dressings.



I was potentially on the cards for a skin graft (re previous posting of a bogan attack riding home one night.. .) anyway, mine was waaaay grosser than yours. (hope that didn't sound up myself sorry) But its healed up fine and i just have a ringbarked neck now.

[hotfoot]

Yep I agree with the last poster...tegaderm and let it granulate up..it could do with some of the mangled skin being removed as it has been exposed to the germy ground and might act as a source of infection.

[toolonglegs]

Heals nicer if you keep it moist.
Doctor has obviously never dealt with roadies!.
I have a big moto related skin graft on my shin... They are fragile and annoying for a long time.

[Ken Ho]

when you go back, ask for a silver foam dressing like mepilex Ag ( you wouldnt want to by theses a the chemist) and leave it there for a week.

Yes, this is basically a burn.
I had a permanent revolving door of this wound from one knee to the other for at least 5 years as a kid. I would not even bother my mother with them, just a good wash under a tap.
However, I suffered a lot of discomfort from the scabs as they dried, and then cracked. A wound dressing that keeps it moist is a good idea. Many things will suffice, from the above mentioned Mepilex, to Tegaderm, or simple gaffer/electrical tape, which is basically the same thing in a less glamorous package.
The king though, is Hypafix, also known as Fixomuls or Mefix. It sticks like shOwtime to a blanket, can get wet and dry again, and allows new skin to form under it. Just put a few layers on in small pieces to avoid creasing, and leave it for a week. You will be amazed at how it heals under that.
I would probably use a bit if gel like Solugel or Solosite in the deeper section for a few days to fill it in a little. It certaily does not need a skin graft. As TLL< noted, his inexperience was really showing there, and TBH, an appt with a plastic surgeon for that wound is bleeding ludicrous.
And yes, I do heal wounds for a living.
If you carry one piece of gear for first-aid on a bike, let it be a piece of Hypafix.

[ft_critical]

Compare the pair. What is the black stuff and how deep? Can't see bone...

http://www.bicycles.net.au/forums/viewtopic.php?f=11&t=23454&start=100

The yellow parts scarred because that is down to the fat cells. Nothing else scarred.

[sogood]

Can't clearly see the detail but the size and depth of the wound doesn't look to be one that'll need skin grafting, nor flap repair. Possible stitches or pack dressing depending whats in those "black" bits. In any case, this is a fresh contaminated wound and now is not the right time to consider skin grafting. Get it dressed (by numerous commercial and traditional options) and wait for it to granulate. The wound will declare itself whether grafting is needed in time.

Heal well!

[jules21]

i feel like a woos now.

in my defence, i think the photo doesn't show the depth of the wound - it goes down a fair way. it's really only that little section in the middle that the medicos are worried about. i needed sleep last night and was about to walk out of the hospital when the doc returned and advised me to see plastic surgeon in outpatients. maybe they're being overly cautious?

[Mulger bill]

Ewww. Near joints is a right pain when it comes to healing IME, lots of stretching of the parent skin.

Might as well see the plastic bloke Jules, don't mean you have to agree with just one opinion.

Heal quick and clean.

Shaun

[wombatK]

The king though, is Hypafix, also known as Fixomuls or Mefix. It sticks like shOwtime to a blanket, can get wet and dry again, and allows new skin to form under it. Just put a few layers on in small pieces to avoid creasing, and leave it for a week. You will be amazed at how it heals under that...
If you carry one piece of gear for first-aid on a bike, let it be a piece of Hypafix.

So where do you get it ? When I asked at local chemists, the best I got was blank stares; some made me feel like an alien
who'd come to take their first born away

[sogood]

So where do you get it ? When I asked at local chemists, the best I got was blank stares; some made me feel like an alien
who'd come to take their first born away

There are way too many commercial options out there with more coming all the time. It's not realistic to expect chemist to know them all. Fact is, outcome varies little.

[Dr_Mutley]

Just rub some dirt on it and get on with it!

Jk!

Should heal fine... Keep it clean & semi moist... Anything from the chemist to facilitate that should be fine....

[Semar]

Why have you taken so long to remove chunks of skin to that depth? Never been on a mountain bike? You'll have a scar of which to be proud! Nerve ending damage will ensure less pain next time.

[Semar]

If you run out of non-stick bandages, you'll be able to explore your falsetto capabilities.

[matagi]

The king though, is Hypafix, also known as Fixomuls or Mefix. It sticks like shOwtime to a blanket, can get wet and dry again, and allows new skin to form under it. Just put a few layers on in small pieces to avoid creasing, and leave it for a week. You will be amazed at how it heals under that...
If you carry one piece of gear for first-aid on a bike, let it be a piece of Hypafix.

So where do you get it ? When I asked at local chemists, the best I got was blank stares; some made me feel like an alien
who'd come to take their first born away

You can get just as good a result using OpSite Post Op which most chemists should know of (some will actually have it in stock). It isn't quite as tenacious as Hypafix/Fixomull/Mefix so it tends to peel off quicker and therefore need replacing more frequently but it will do the job.

[foo on patrol]

Bandage and heal Jules.

I had one on my knee that was the size of that and the Doctors at Bundy hospital said that I would need plastic surgery/skin grafts because you could
see the white tissue, that I'm guessing was fat. I can't even see where it was now, but it did take ages for it to heal properly.

Foo

[U2adam!!!]

I admit it... I only clicked on this topic because of the image warning and have nothing beneficial to add.

Tim

[Percrime]

+1 for mefix. Us trackies know such things

[jules21]

Why have you taken so long to remove chunks of skin to that depth? Never been on a mountain bike? You'll have a scar of which to be proud! Nerve ending damage will ensure less pain next time.

i've done my share and i've always just bandaged them, but this one was deep. the photo doesn't really give perspective but there's a big hole dug out of my elbow. nurses/doctors have variously responded with "it will definitely won't/might need a skin graft" they can't make their minds up, lol. it's feeling pretty good so if i reckon it's healing up i will cancel my outpatient appt. for tuesday.