Wound Care
Good advice here on evaluating if you have infection and what to do if so.
In the "next time around" department here are some tips gleaned from raising a road/cx/mtb racer who has had his share of crashes, pavement surfing and whatnot (not that I haven't!). I'll cover it in terms of what we keep in our road rash kit.
Item 1: A new, unopened toothbrush
What it's for: Debriding the wound. With the toothbrush, soap & water start scrubbing to get all the gravel & debris out. When it starts hurting a lot, you've begun to do it right...keep it up until you've debrided the whole area and the whole wound is pink or red (from bleeding). You should not be able to see any dark specs left in the wound. If it's too painful or you think you might pass out, go to the e-room where they'll do the same thing...though they might give you some local anesthesia first.
Item 2,3,4 & 5: Tegederm, small guaze pads, bandage tape, vaseline & q-tip(s)
What it's for: Tegaderm or other waterproof breathable dressings are expensive, but work really well for promoting healing without scabbing. Why would you want healing without scabbing? THEY claim healing happens faster (couldn't tell you), scarring and discoloring are less (I think that's true) and the wound area remains more flexible during healing (definitely true). Also, if done right, you can stick this stuff on and leave it on through showers, etc. Anyway, I've seen recommendations for it from several biker/doc types and have personal/family experience both ways and I'm sold.
The Tegaderm (comes in different size sheets) should overlap the wound by 1"+ all around, so it can stick to dry skin. It won't stick to the wound, which will probably still be weeping from your scraping the s__t out of it with the toothbrush.
BEFORE you stick the Tegagderm on, do this: take the q-tip, dip it in the vaseline and paint a strip the width of the q-tip from the wound to outside where the Tegaderm will cover. This will be a drain pipe for secretions. It should be oriented wherever down will be most of the time. You can put 2 in if you want; say one that is down during the day & one that is down while you're sleeping. At the end of the drainpipe (after the Tegaderm is on) tape a small guaze pad; this will absorb the fluid and you can change it out as needed. If you don't put a drain pipe(s) in, the fluid will build up under the Tegaderm and you'll have to change that more often, which is spendy and unneccessary if you drain the fluids.
If the area is difficult to bandage due to location, (say a joint, as opposed to mid-limb) you may have to replace the Tegaderm more often. You can also put some tubular stretch net (Surgilast) over the tegaderm to help prevent the edges from getting peeled off. The netting is also great for holding on traditional gauze wound dressings w/out a bunch of tape, but I'm a believer in the moist healing program. Best of luck.
