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Paria Trip in Jeopardy!
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Matt Hoffman





Joined: 18 Feb 2004
Posts: 701
Location: Grantham, NH

PostPosted: 4/8/2007, 10:39 pm    Post subject: Paria Trip in Jeopardy! Reply to topic Reply with quote

I am supposed to leave for Paria on Wednesday morning. My girlfriend and I have been looking forward to this trip for about 6 months.
On Saturday, I decided it would be fun to crash my mtn bike hard, and open a DEEP gash above my right knee. It hurts pretty good; right now the pain is a dull throb. I've been trying not to bend my knee, because I don't want the wound to open up. It's been oozing a bit since Saturday afternoon.
Anyone have any suggestions on how to make a wound like this heal quickly? I have it loaded with Neosporin and I'm changing the band-aid/gauze twice a day. I don't want to bail on Paria, but I'm afraid I'll have to.
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CatValet
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Joined: 04 Jan 2003
Posts: 735
Location: Scottsdale

PostPosted: 4/8/2007, 11:30 pm    Post subject: Reply to topic Reply with quote

Rest, Ice, Compression, Elevation. (RICE) I would take a NSAID like Ibuprofen or Naproxyn at heavy doses (600 mg Ibuprofen every 8 hrs or 500 Naproxyn every 12 hrs) to treat the inflammation. I would sleep with the knee elevated on a couple pillows. I would also wash wound well with a mild antisepticsoap like Hibiclens (no alcohol or iodine in the wound-although a little B&B on ice would help your tummy)

If there is any gaping in the wound, I would butterfly bandage the gap shut well and then tape over the butterflys with adhesive tape. A light wash of tincture of benzoine on the EXTERNAL skin make it sticky and the tape holds better. 24 hrs later is a bit late for butterflying a gap, or even suturing, but worth a try. An "old wound is hard to suture after the fact, and usually granulates in with a manly scar. (although rubbing Vitamin E on it diminishes the scar, if you are worrying how you will look in panty hose later)

72 hrs can make a big change in such a surface wound. If it is still open and draining a bit on Wednesday, I'd dress it with neosporin like you are doing and cover with spenco second skin (the blue stuff) and adhesive and go for Paria-it's a great hike. Will probably require daily redressing and irrigation/cleaning with soap or Hibiclens while on the hike. If there is any redness or signs of infection on Tuesday, you might sweet talk your doctor into a ten day dose of a broad spectrum antibiotic like ciprofloxacin or doxycycline to keep the wee beasties at bay.

This is all stuff I carry in my medical kit-including the B&B. Those little 2 oz nalgene bottles are great to carry benzoine and hibiclens, as well as some betadine as well, which in a pinch can treat water. Keep us posted.
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Matt Hoffman





Joined: 18 Feb 2004
Posts: 701
Location: Grantham, NH

PostPosted: 4/8/2007, 11:53 pm    Post subject: Reply to topic Reply with quote

Wow! Your response was above and beyond! Thanks!
I did butterfly the wound yesterday. I've cleaned it thoroughly. I shaved all the hair off my leg around the wound so that the bandages will stick better. I am about to redress it. The best I can do is Neosporin, and a band-aid treated with antibacterial stuff. I don't even have any pain killers at my house except for aspirin...which I never take (not even sure why I have it).
I will try to keep it elevated. Today was hard, because I was in a car for 6 hours, and tomorrow will be more of the same.
Is ice neccessary? It's not swollen or anything.
I'll go out and get some Spenco 2nd skin and Hibiclens tomorrow. Thanks again!

If you any of you mtn bike and read Mountain Bike Action magazine, there was an article in a recent issue with riding tips. One of the tips was "charge the terrain." I'd rethink that tip. I followed it....and uh...the terrain won. Sad
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RedRoxx44
Queen of the Walkabout




Joined: 15 Jan 2004
Posts: 1167

PostPosted: 4/9/2007, 4:35 am    Post subject: Reply to topic Reply with quote

Where are our nurses??? I would second the antibiotic to take on trip, in case you come down with some sort of infection if it still is slightly open. The newer bandages that have some moisture to them and made to stay on several days seem to work well, just have to make sure that wound is ultra clean.

You know you will be bending the knee while hiking so once that thing looks like it's knitting I would carefully try some range of motion and put a little stretch on that scar.

Good Luck--
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BoyNhisDog
The dangerous place where the winds meet




Joined: 05 Jan 2003
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Location: Tucson

PostPosted: 4/9/2007, 5:10 am    Post subject: Reply to topic Reply with quote

Keep cleaning it with betadine and smearing the Neosporin on it. You can pack it with sugar as well. Bacteria cannot grow in that. I cut off the tip of my finger once and did the routine above and it worked well. Other than that youth is on your side for fast healing. Some bike injuries are not clean cuts so they take longer to heal. Too bad it got your knee. If you still think you can manage it, then take the thing above and keep it clean and dressed. Good luck!
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Suz





Joined: 27 Nov 2005
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PostPosted: 4/9/2007, 6:24 am    Post subject: Reply to topic Reply with quote

Bummer Matt

Maybe if you do all of the stuff everyone suggested it will be healed enough that you can seal it up with that liquid bandage stuff????

Good news is that Paria isn't going any place should you decide to hold off on the trip and take care of the knee. Best wishes for a speedy recovery!
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Hikngrl
Canyoneering is my 'Happy Place'




Joined: 27 May 2003
Posts: 5578
Location: Peoria, AZ

PostPosted: 4/9/2007, 7:22 am    Post subject: Reply to topic Reply with quote

Don't use betadine it kills healthy tissue. keep it good and clean but don't scrub and open up healing tissue. You should have plenty of time to get it healed enough to make it safe to go on your trip!

There are dressings out there now that are a lot like a dressing we call Tegaderm that can be applied to the wound and as long as it stay on and sealed against the skin can be left on for a day or two. Apply it to good clean dry skin and allow your body heat to seal in onto your skin over night or at least for several hours prior to becoming to active. If for any reason the seal breaks between your skin and the dressing then don't leave it in place as then it will be a nice warm environment for crap to grow. In that case then just remove cleanse and replace with a different dressing....All of Randy's suggestions are wonderful!

Don't give up on your trip!
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Matt Hoffman





Joined: 18 Feb 2004
Posts: 701
Location: Grantham, NH

PostPosted: 4/9/2007, 7:47 am    Post subject: Reply to topic Reply with quote

Excellent!
Thanks for the positive responses! Last night was a good night as far as healing goes. I kept my leg elevated and really didn't move all night. The wound still hurts a bit, but it seems like it's the shallow scrapes around the deep wound that hurt more.
I'm gonna raid Walgreens in a little bit. I think Paria will happen. I might just have to go really slow. What a shame. Rolling Eyes
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Davis2001R6





Joined: 12 Dec 2003
Posts: 5591
Location: Italy

PostPosted: 4/9/2007, 8:57 am    Post subject: Reply to topic Reply with quote

Sounds a bit like a knee wound I got when I fell in a hole in canada and contacted a metal drain pipe. But I had all the swelling to go along with it. Went to the doctor the next day after work, said it was too late to stitch it up in case of infection. Just kept it clean and tried to keep it open when I was at home so it could close up. At work it sucked because I was doing a lot of movement and had to wear pants, it kept it too wet to scab/close up so it took a few days longer and oozed some. Good luck!
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Nighthiker





Joined: 05 Jan 2003
Posts: 1714

PostPosted: 4/9/2007, 10:00 am    Post subject: Reply to topic Reply with quote

If it is just a soft tissue injury you should be able to make the trip. Read the same article but I don't charge ahead, I outflank. Article in the Sunday Republic about Paria. Several of my roadie friends have augered the past two weeks, one had to but a new helmet the other a bike.
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Canyon Dweller





Joined: 06 Jan 2003
Posts: 712
Location: Denver, CO

PostPosted: 4/9/2007, 11:02 am    Post subject: Reply to topic Reply with quote

instead of Neosporin I would recommend Doctor Burts Res-Q-Ointment. It contains Lavender Oil which is suppose to be good for healing wounds. My wife and my sister took classes that taught them to never use anyting that has mineral oil or petroletum jelly in it. My sister is an expert in skin health, and told me that they both stop cell growth and prolonged use is detremental to the skin.
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CatValet
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Joined: 04 Jan 2003
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Location: Scottsdale

PostPosted: 4/9/2007, 11:08 am    Post subject: Reply to topic Reply with quote

Diane is so right about the Betadine. Antiseptics like that are for external use only, as they kill living tissue. Then, to finish Diane's thought, the necrotic (dead) tissue becomes a breeding ground for all sorts of bad stuff. That's why the old "whiskey soaked rag through the arrow wound" stuff is great for old John Wayne westerns, but bad field medicine. Same reason that so many injured soldiers in the Civil War (sorry Todd & Mike, for you, "The War of Northern Aggression") died from gangrene. That's why I carry the Hibiclens surgical scrub for wound irrigation.

Glad you're doing better, Matt.

PS- while we're on this thread, I highly recommend the latest edition of Dr. Thomas Forgey's book "Wilderness Medicine" as the Bible on the topic. Dr. Eric Weiss' similar book is good too.
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threedogz





Joined: 06 May 2005
Posts: 668
Location: Chandler

PostPosted: 4/9/2007, 2:43 pm    Post subject: Reply to topic Reply with quote

my question to you is what is it oozing? Blood? Pus? Or a light pink fluid like stuff that is fairly clear?
If the drainage has an odor or puss looking ooze, then it is infected...if its pink/watery looking, its pretty normal drainage.

And second question how big is the gash? It may need stitches. Any neosporin or bacitracin would work on cuts/abrasions, but if its a large gash, it should be irrigated and stitched up.

Oh, it would be a no-no to use Hibiclins on an open wound, it is good for scrubbing prior to surgery and cleaning a CLOSED incision site. I know this first hand by working with Open Heart Patients because this is the main staple of mid-sternal surgical infection prevention.

Most cuts, abrasions and small gashes can be managed with normal saline wash and cover with a dry gauze if you are a healthy person. The main thing is to keep clean and dry....
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BoyNhisDog
The dangerous place where the winds meet




Joined: 05 Jan 2003
Posts: 1375
Location: Tucson

PostPosted: 4/9/2007, 3:10 pm    Post subject: Reply to topic Reply with quote

Looks like I need to update my medical book. Mr. Green Those are the directions I followed but the betadine info from Diane and Randy does make sense when I look back on it. Glad we have up to date medical personnel here.

Years ago we took a friend to the emergency room after a bad bicycle crash. The nurse said to scrub a wound like that out with hot water and a wash cloth even if it hurt. That was for the first time to get gravel and dirt out but then let it heal and do not re-scrub it. We ended up taking a couple of our companions to the emergency room over the years but most of the rest just lived with it and let it heal. I went in for bike crash injuries and got 10 stitches to my head around the eyebrow area. Actually a woman took me. I didn't even care about my injuries, I just kept looking at my bike and asking if it looked okay, spinning the front wheel as I dripped blood in my eyes down my body. I remember the doc asking me a question so I tried to lift the cloth they place over the area when the doc is trimming and sewing. Man did that nurse yell at me to not touch that sterile field. Surprised Mr. Green I just said, please don't hit me and she smiled. I will tell you that head wounds like that bleed like no other wounds. I was just dripping.

I have scars on my knee, various on the legs, arms, shoulder and hip from bike crashes. I have injured myself so bad from several decades of bike riding that I cannot ride road bike or mountain bike anymore. Its all good Matt. Mr. Green You just do what you can till you have to do something else. I hope the Paria works out.
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Matt Hoffman





Joined: 18 Feb 2004
Posts: 701
Location: Grantham, NH

PostPosted: 4/9/2007, 5:43 pm    Post subject: Reply to topic Reply with quote

Thanks everyone for the replies! You guys are all so smart and awesome! That's why I ask...thanks again!
I seem to be doing really well today. Paria is going to happen. I bought some waterproof bandages and some 2nd Skin spray so I'm good to go. I have much more range of motion today as well.
I bought some Hibiclens, but I think I'm going to take it back to the store ($10!!!! dang!). I think I'll use saline instead.

Thanks again everyone. I'll let you know how the trip went when I get back.

threedogz, the "ooze" is the mostly clear stuff. I have just as much ooze coming from the smaller cuts around the big one. I think maybe it's not as bad as I first thought.
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