G. Roxy Lupien, CNL, CWOCN, CFCN and Radoslava Stoddard, CWON, CFCN, Nursing administration, SSM SLUH, Saint Louis, MO
The terms road rash and road burns are colloquialisms for friction burns resulting when the skin is scraped off by contact with some hard object such as the ground. Medical management is the same as for a thermal burn: intravenous fluids and shock resuscitation. Road rash can occur on any body part and is more painful than a cut due to exposure of larger areas of skin and nerve endings. If left untreated, they can become infected, scar, and contractures of the scar can occur due to the road debris introduced into the tissue. Pain management is also required for local wound care. At times, the degree of pain management needed to facilitate effective local wound care can delay discharge from the acute care setting. In our urban level 1 trauma center, the current treatment is bacitracin ointment twice daily or alternatively silver sulfadiazine cream 1% once or twice daily. Ideally, ointments and creams are removed by wound cleansing with each application; this is often done ineffectually or sometimes not done at all, due to pain.
We were introduced to a new multifunctional surfactant-based biomaterial whose component is both hydrophilic or ‘water-loving’ and hydrophobic or ‘oil-loving’. We completed a series of three case studies for significant partial and full thickness wounds treated with the surfactant-based biomaterial dressing. Treatment demonstrated rapid wound healing, minimal scarring upon healing, and decreased pain immediately after the first application. Opioid addiction is a current public health crisis seen at epidemic numbers. Long term opiate pain management has shown to lead to addiction, our wound care was completed without the requirement of pain medications for subsequent dressing changes, offering both the patient and healthcare team with safer, more effective, treatment options for road rash.