"Road Rash" Thermal / Friction Injury
Common term for what is in fact a friction burn (not truly a dermatologic rash)
CLINICAL: most common non-thermal burn. Typically seen < 20yo in trauma with associated concomitant injuries (fractures, head trauma, bleeding etc)
PHYSICS: friction--> generates both structural and thermal injury. Severity is determined by depth
1. Epidermal -> painful/red "strawberries" from sports turf burns
2. Superficial dermal -> painful
3. Deep dermal -> limited blanching. May have reduced sensation
4. Full thickness -> no blanching, possibly white or black. May not be painful at all
5. Deep structures -> injury to deeper structures (muscle, tendons etc)
APPROACH:
NOTE: when severe, treated similarly to thermal burns.
Will need fluid resuscitation, Tetanus prophylaxis, pain control, full trauma survey. May need admission to Burn ICU with consult to plastics and/or needed skin grafting. For smaller areas -> may used topical lidocaine jelly (calculate max dose prior to application). May need antibiotics for dirty/contaminated wounds, which is different than normal thermal burns that don't typically require antibiotics.
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