Ok, I had a pretty bizarre ski accident last weekend where my the end of my pole went into the back of my calf, pretty much right in the middle of it. It didn't even break my ski pant, but it created almost a rip in my flesh that's about 1cm deep and 2cm long top to bottom. I've been taking good care of it using synthetic stiches and washing and disinfecting it twice a day. There is bruising around the wound as well, but not as bad as I was anticipating considering the cut. The cut is closing up well.
So this happened 5 days ago now. I'm still limping a bit, but it's feeling a fair amount better than before. This is of course prime base building season and I was hoping to at least get in 2x2hrs this weekend, if even a touch more on one of the days.
Am I stupid? How long to these kinds of tissue injuries generally taken to heal?
Thanks weenies!
Length of layoff after calf puncture wound?
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I do this for a living, and there's honestly no fixed length of time like there is with broken bones. Use pain as a guide, e.g. if turning the cranks makes you wince, you probably shouldn't be on the bike. On the other hand, if it feels fine, have fun.
The most important part is wound care, as doing it wrong can result in a serious set back. You're doing it right so far, but watch out for redness/tenderness, frank bleeding or purulent/pus-like discharge. So long as those don't crop up, you won't be set back any. If the puncture is agape, consider lightly packing the 1cm depth with clean, moist gauze and covering it each time you do a dressing change. This will allow the the wound to heal from the inside out rather than just seal at the surface leaving a void for an abcess to form. If it's too narrow for this, just continue what you've been doing.
The most important part is wound care, as doing it wrong can result in a serious set back. You're doing it right so far, but watch out for redness/tenderness, frank bleeding or purulent/pus-like discharge. So long as those don't crop up, you won't be set back any. If the puncture is agape, consider lightly packing the 1cm depth with clean, moist gauze and covering it each time you do a dressing change. This will allow the the wound to heal from the inside out rather than just seal at the surface leaving a void for an abcess to form. If it's too narrow for this, just continue what you've been doing.
Last edited by AGW on Wed Mar 05, 2014 4:50 pm, edited 1 time in total.
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AGW- wicked, thanks for that. Yeah, I understand the pain-guide thing, it seems to work quite well. I was looking to see what is the 'normal' time table for tissue repair. You make some really good comments about the wound cleaning and how it's going to heal. I'll try your trick, I too am worried about it closing up on the surface and leaving a void so I've split the surface tension after wetting the scab with alcohol each time. Is there any skin healing cream etc I should use, or should I steer clear? Thanks!
Time table depends on wound care and nutrition. It's a small wound on a fit (and thus presumably well-noursihed) individual, so I would expect there to be little more than a pink scar in a month's time. If you were to start packing it, simply soak a thin strip of gauze in sterile saline or sterile water available at any drug store (no peroxide or alcohol in the wound), and lightly insert/pack down. Pulling the (now dry) gauze out will hurt later on, but this debrides and allows new growth faster. It's called a "wet/moist-to-dry" dressing. The hole will get narrower and shallower much more quickly. Eventually you won't be able to pack anything, and this is when you can proceed to just a bandage on the surface. An antibiotic ointment (neosporin, bacitracin, etc.) around the outside of the puncture is fine, but not really necessary as long the skin is kept clean.
An anecdote: I took care of a gentleman who had suffered a shotgun wound to his abdomen. As he lay on his side, I could insert my hand into his peritoneum from the back and grasp the fingers of my colleague whose hands were inserted from the front. We would pack his abdomen full of moist gauze (2-3 large rolls of kerlix...) twice a day for a week or two. He later came back to visit after some rehab (8 weeks?) and showed me a small, coin-sized pink divot on his stomach where there was once a grapefruit-diameter channel from front to back. Optimal nutrition and consistent wound care.
An anecdote: I took care of a gentleman who had suffered a shotgun wound to his abdomen. As he lay on his side, I could insert my hand into his peritoneum from the back and grasp the fingers of my colleague whose hands were inserted from the front. We would pack his abdomen full of moist gauze (2-3 large rolls of kerlix...) twice a day for a week or two. He later came back to visit after some rehab (8 weeks?) and showed me a small, coin-sized pink divot on his stomach where there was once a grapefruit-diameter channel from front to back. Optimal nutrition and consistent wound care.
Good advice from AGW. One of the things that bothers me at times in my practice is all the things people put on cuts to sterilize which usually end up stripping away the fragile newly forming tissue. Soap and water is as good as anything for cleaning outside of the OR. Stay away from antibacterial soaps, the additives are bad for you and bad for the environment. Soap by its nature is antibacterial and doesn't need harmful additives.
Wet to dry dressings are great for micro deriding, particularly dry ulcers. In a healthy person with a simple wound they are probably not all that necessary. Duoderm is great as well for road rash and slow to heal wounds as they soften the dry eschar, provide coverage and promote the formation of a flat soft scar.
Some antibacterial creams can cause irritation and dermatitis, particularly neosporin. I would stay away from creams in general as when they get older they often become somewhat acidic, not nice on road rash favour ointments. I quite like the brave little soldier ointment as it has some lidocaine in it, wonderful for road rash.
I agree with the let pain be your guide guideline here. Soft tissue is hard to predict. General aches from stretching a sore muscle is okay, sharp pains not as much, radiating pain watch out.
Good luck, remember a couple weeks off for an injury may just provide the rest you need to improve in the long run.
Wet to dry dressings are great for micro deriding, particularly dry ulcers. In a healthy person with a simple wound they are probably not all that necessary. Duoderm is great as well for road rash and slow to heal wounds as they soften the dry eschar, provide coverage and promote the formation of a flat soft scar.
Some antibacterial creams can cause irritation and dermatitis, particularly neosporin. I would stay away from creams in general as when they get older they often become somewhat acidic, not nice on road rash favour ointments. I quite like the brave little soldier ointment as it has some lidocaine in it, wonderful for road rash.
I agree with the let pain be your guide guideline here. Soft tissue is hard to predict. General aches from stretching a sore muscle is okay, sharp pains not as much, radiating pain watch out.
Good luck, remember a couple weeks off for an injury may just provide the rest you need to improve in the long run.
Yup, great advice. I'm against most 'ointments' myself.
Update- it's closed up now but I think I did pretty well to avoid having a void in there and so far there's no sign of any infection. Of course my leg is going through great shades of green and yellow now from the bruising, but I'm able to walk w/out a limp now. I've been doing low intensity riding with minimal standing and so far so good. Definitely focussing on not putting any pressure through the pedals, really just spinning. To be honest, I'm generally guilty of ramping up the gears too quickly this time of year, so this is probably good for me in the end.
Update- it's closed up now but I think I did pretty well to avoid having a void in there and so far there's no sign of any infection. Of course my leg is going through great shades of green and yellow now from the bruising, but I'm able to walk w/out a limp now. I've been doing low intensity riding with minimal standing and so far so good. Definitely focussing on not putting any pressure through the pedals, really just spinning. To be honest, I'm generally guilty of ramping up the gears too quickly this time of year, so this is probably good for me in the end.
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