Training & Nutrition - Not sure where else to ask... Road Rash treatment?

I read a bunch of stuff on how you should keep road rash covered and moist so as to keep it from scabbing and scarring. This happened saturday, and was from a mild brush-up against a concrete wall.

I am currently using Johnson and Johnson Advanced Healing pads to cover the affected area. These are a "Second skin" aquagel type dressing, which absorb and evaporate leaking fluids from your body, while sealing the wound away from water, bacteria and dirt.

I keep getting leakage from the edge, though. The leakage is a translucent orange color. It is thick like pus, but darker and totally odorless. Apparently, it's mostly blood plasma and platelets but I can't verify this. I simply wipe it away with a wet cloth and push some excess out from under the dressings when it seems to get excessive.

Daily, right before I shower, I remove the dressing, then flush it with a skin-temperature 50% water/hydrogen peroxide mixture, then rinse it thoroughly with clear skin temperature water. After I shower, I dab it dry with a cloth and re-cover it. The "second skin" coverings turn white again over the injury, which means they're absorbing leakage, and which means my wound still is leaking.

The wound doesn't seem to be infected nor does it hurt like an infected wound.

2 questions:

1) Is the leaking fluid a bad sign? It's been about 72 hours since the scrape. It looked like this when I got back to the trailhead (http://www.focushacks.com/photo/amputation.jpg)(2 miles of riding after the scrape)

2) Should I just leave the dressings on while I shower and avoid flushing the wound? they seal pretty good, and would probably last through a shower or two without coming off.

See you family physician ASAP - this isn't gratuitous advice. Also ask if you need a tetanus booster.

I got a tetanus shot when I broke my face in March.

Actually, I found a thread in the roadie forum regarding road rash. It seems the main mistake I'm making is using peroxide to flush it out. I'll keep an eye on it, but as long as it's healing and the drainage doesn't start to take on a funky smell, it seems like it should heal up nicely in the next few days.

increase your protein intake for faster healing and less scarring. Up your vitamin E as well.

Polysporin and loose guaze pads. Polysporin will keep infection at bay and the guaze will keep polysporin off your clothes and let your rash breathe.

On Sunday I got a road rash patch on my knee that looked much worse than that. I went looking for Tegaderm (which is what I've seen recommended) but I ended up with a Band-Aid brand second skin spray. The wound looks a lot better at this point...no leaking or anything.

What you are seeing is normal tissue juice, it is a bit orange,
maybe slightly red depending on # red cells. Its presence
indicates the wound is staying fresh and moist. What you
want to avoid is the scab formation and the prescab state
with a wet yellowwhite membrane on top of the abrasion.
Both can be stripped off with a little pain. Pink tissue is
what you want to see which will slowly epithelize over 1-3
weeks depending on size and depth of abrasion.
Infection will be obvious as it noticeably increases the
pain in the abrasion. Treated as you originally described,
(sans the peroxide) the abrasion should be relatively
painless when bandaged with the second skin, Johnson's
dressing or tegoderm. As one other poster noted tegoderm
lets juicy stuff accumulate underneath which tends to float
off the tegoderm and for larger abrasions it can get expensive
to cover and hard to put on with out some experience.
It is best for smaller abrasions.

As to your pix, looks like a shallow dermal abrasion which should
heal in about two weeks or less. Dressings may be left on if
not damaged by wetting (tegoderm in my experience can last
a week or more in showering) and the wound is not juicy.
Juicy wounds need more frequent dressing changes. The juice
has to be dealt with.

My road rash continued to leak for about 2-3 weeks. You're only at 72 hours. You've got a long way to go!

You might try some zinc oxide (found in baby departments) around the edges of the road rash where it is starting to heal. That seemed to help me. Then in the middle at the worst part of the road rash use Ozonol or Polysporin or one of those. That seemed to ward off infection.

6 weeks later, I've got scarring, but it is nowhere near as big as the original road rash.

This was how it looked about 6 weeks ago: http://ca.pg.photos.yahoo.com/ph/machka999/detail?.dir=1c0cscd&.dnm=b4a1scd.jpg&.src=ph
It looks MUCH better now. :)

What you are seeing is normal tissue juice, it is a bit orange,
maybe slightly red depending on # red cells. Its presence
indicates the wound is staying fresh and moist. What you
want to avoid is the scab formation ...

+1,what he said
if you have the wound clean now, further use of peroxide will dramatically slow healing and the formation of new cells.
Even applications of antibiotic ointments will have a toxic effect on these new cells. Use antibiotic cream if you start feeling increasing tender to touch and heat from the wound. The interstitial fluid leakage will continue for a bit, but thats normal.
Try not to let that hard scab form, thats a formula for longer heal times. I prefer to keep the dressing on during short showers and change when it starts showing its drying out.
Stop the peroxide and the fluid leakage will reduce greatly.
An option for showering, which I used for my large area wounds of last August - during showers I covered the wound/dressing areas with a plastic bag with both ends open. Bag was held up on the thigh with a large rubber band. Not totally water proof, but the slight water leakage was minimal, and the bag kept the strong shower stream off the dressings, so they stayed on better. After I finished cleaning rest of body, the plastic bag came off and I cleaned around the wound area using a sponge. Did this both on the leg and the forearm wound areas. worked great

Yeah, don't do the peroxide, it kills off new cells and will extend the healing time. Use a triple-antibiotic ointment instead. Then cover it up with a dressing. That wound's not bad at all and if you change ointment/dressing twice a day, it'll be completely gone in a week with no scarring.

One final treatment I've found works well for minimizing scarring is when the wound's completely covered with new pink skin, you should still protect it. It's still delicate and can get infected or blistered by the sun. Use high-IU vitamin-E cream over it and keep gauze over it for another 3-4 days. Once the new skin starts regaining its original color, you can then stop the vitamin-E.

tegaderm dude. woman in my group went down hard in march, a lot of facial scraping and she used tegaderm...here's picture of road rash:

http://www.trianglecycling.com/gallery/files/4/2/IMG_0196Small.JPG

after:
http://www.trianglecycling.com/gallery/files/4/2/IMG_0251.JPG

i know you can't see the side that was injured so well in the picture, but trust me, there is no scars what-so-ever on her face.