Gravel rash and hydrocolloids ‘step-by-step.’

Gravel rash…adults and kids get it — falling off a bike or skateboard- sustaining nasty grazes. OUCH!!! What looks like such a superficial wound can be absolute agony for days.

Critical to pain reduction in the management of these wounds is knowing what wound dressing will give the best results, as well as being the most cost-effective, BUT how often does some well-meaning person ‘paint’ the bleeding graze with a coloured antiseptic solution and cover it with dry gauze – and how painful it is to remove!! The gauze hardens and it can take many hours of soaking and gentle pulling –amidst tears, squeals and fresh bleeding, to remove it.

Here’s how you can make it easier for yourself and your patients with a cost effective, secure, dressing that is like a second skin’ and will not stick to the wound surface?

Step by Step

1. wash the grazed area –under the shower is fine if your water is clean – picking out as much gravel and dirt as you can.
2. pat the grazed area dry, especially the surrounding skin.
3. apply a hydrocolloid dressing over the graze with a large margin around the edges of the wound.
4. if the graze is over a joint, i.e. the knee, you can use two or more pieces, overlapped and/or make sure the joint is slightly bent.
5. press gently all around the margins of the hydrocolloid for a few minutes – the warmth of your hands will aid the adhesive process.
6. you will notice that there is immediate pain relief. This is because you have just covered all the nerve endings in the dermis.

When should the hydrocolloid dressing be changed?

‘A week or a leak’ is good to remember. The hydrocolloid dressing can stay in place for a week but you will often find that the exudate (leakage that looks like pus & may have an odour) starts to leak out before this time. Don’t be alarmed. It is unlikely to be pus. This exudate is quite normal. You will see bits of gravel in the jelly like exudate. Repeat steps 1-6 again until the exudate has ceased and there is new pink epithelial tissue. Most grazes will heal within 3 weeks or so. If there is increasing pain, fever, offensive smelling pus consult your doctor.