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A bit of sand on the road, a puddle in the bend, a braking error on the descent, and it's already happened: The rear wheel slips, you lose control and your bike skids across the grey asphalt. Ouch! It's good if such an accident only results in grazes. But even these should not be underestimated. They can only heal without complications or scars if they are treated properly. In most cases, only the top layer of skin, the epidermis, is abraded. Smaller blood vessels are often damaged in the underlying dermis, which is why pinpoint haemorrhages can be seen in the wound.
Abrasions
Because nerve endings are exposed in the dermis after the epidermis has been abraded, the wound burns painfully. Dermatologists call a superficial abrasion "erosion". If the dermis is damaged as well as the epidermis, they call it "excoriation". A deep abrasion with leathering of the subcutis is called "avulsion". The rule of thumb is: the harder and rougher the surface that the skin rubs against during a fall, the greater the abrasion and the deeper the wound. "After bike crashes, we mainly see abrasions on the legs, but also on the buttocks, arms, elbows and shoulders," says Sebastian Zimatschek. The specialist in anaesthesiology has headed the rescue team of the TOUR-Transalp since 2003, in which around 1000 participants cross the Alps on racing bikes in seven stages every year. The rescue team rushes to the aid of casualties on motorbikes or by ambulance and also treats them in the start and finish areas.
"Body check" after the fall
Up-to-date tetanus protection is always important. Zimatschek therefore appeals to all cyclists to check this: "The vaccination must be refreshed every ten years, otherwise even a small graze can be fatal." After a fall - whether during sport or a leisure tour - you should first think about safety. Zimatschek: "People are often shocked at first and don't realise that it's dangerous to stay on the road for too long. But if the injuries allow it, you should get to safety as quickly as possible." The doctor then recommends a brief "body check", as he calls it, to anyone who has fallen: "Although abrasions are often the first thing that catches the eye, you should take the time to briefly check the whole body from top to bottom for injuries and move around: Does it still hurt anywhere?"
If there are only abrasions, these must be cleaned. "Dirt, soil, stones and clothing residue should be removed as quickly as possible," says Zimatschek. He recommends using a Non-flammable disinfectant from the pharmacy, which cyclists should ideally carry with them on every ride along with other first aid items. If necessary, clean water from a water bottle can also be used for cleaning. Afterwards, abrasions should be covered with a sterile compress using non-adhesive wound dressings, "because a normal plaster would stick to the wound".
You should be immunised against tetanus just because of an abrasion
Tetanus is caused by the toxin of the bacterium Clostridium tetani, whose resistant spores are found almost everywhere outdoors and can enter the body via small stones or splinters in wounds. Without vaccination, the infection leads to a severe course of the disease, which is sometimes fatal even with intensive medical treatment. Even children should be immunised against tetanus. Adults must be immunised every ten years.
Injured skin needs rest
It can be difficult to organise professional help on a holiday or leisure trip when the nearest larger town may be far away. And you don't want to call the emergency doctor straight away because of a graze. According to Zimatschek, you can continue cycling without any major concerns if "only the knee is a little scraped, well disinfected and covered". However, if tendons, muscles or nerves have been damaged, it is better not to continue riding. And one thing is certain: "It is not ideal for healing if the injured skin is repeatedly moved while pedalling and comes into contact with sweat," says Zimatschek.
Cleaning, disinfecting and covering prevents infection. Afterwards, the wound needs rest above all. And stay away from supposed household remedies such as flour, oil or onion juice! These can actually promote inflammation. Signs of an infection are heavily reddened wound edges, pus and throbbing pain. "If the surrounding lymph nodes are already swollen, for example in the groin after a knee abrasion, then it's high time to see a doctor," warns Zimatschek. The same applies if you have a fever, an abrasion is very painful, is bleeding heavily or still looks dirty despite cleaning. A very deep wound may also require stitches.
What Dr Andrea Demmler, dermatologist, says
Dr Andrea Demmler, a dermatologist with her own practice in the Main-Spessart district, who spends a lot of time on her racing bike as a triathlete, also advises special attention: "A wound can start to fester or develop erysipelas even a few days after the fall." The dermatologist recommends supporting the healing process with a wound healing gel if necessary and protecting the wound from the sun for the first three to four days. "UV light interferes with healing and increases the risk of scars remaining." As long as a wound is oozing, plasters or compresses should be left on anyway. A dry wound can manage without plasters after a few days. "You should then avoid swimming or bathing for the time being," says Demmler - because of the risk of infection and because it interferes with healing. There are special shower plasters for the shower.
According to Demmler, how quickly an abrasion heals is partly genetically determined, but also depends on age and previous illnesses. The body's repair mechanisms start immediately after the accident. To stop the bleeding, the vessels in the wound constrict to minimise blood loss. "A protective yellowish-transparent layer then forms on the wound surface," explains dermatologist Demmler. "This is called fibrin. Underneath it, inflammatory cells of the immune system clean the wound, eliminate germs that have penetrated and produce growth factors." After a few days, specialised cells, the fibroblasts, begin to build up new skin from the lateral edges. "After about a week, the worst is over," says the triathlete, "after two weeks there is often hardly anything left to see." At least if only the top layer of skin has been rubbed off.
Sun protection for abrasions
The deeper the wound, the more likely it is to leave a scar. To avoid this, you should protect it with sun cream, says Demmler - even if the scab has long since fallen off. Otherwise you risk not only an unsightly scar but also red spots and differences in pigmentation. Depending on the depth of the injury, a scar will only fade significantly after ten to 15 years. If you don't want to wait that long, you can have the scar treated cosmetically in a dermatological practice, for example with cortisone or laser. However, you should not wait too long for treatment. In the best case scenario, the abrasion was only superficial. And was then treated so well that soon only the scratches on the frame are visible.
This belongs in the first aid kit
- Non-stinging wound disinfectant
- Sterile wound dressings
- Non-adhesive wound dressings
- Rescue blanket
- Disposable gloves
- Emergency telephone numbers
A large selection of first aid kits is available, for example, from Mountain friends or Decathlon.
