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Published on July 27th, 2011 | by Papa Doc

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Infection: Another Blocker on the Track

This column provides a general overview of Roller Derby medical problems and their initial treatment, and it is not intended for advice for an individual. Therefore, you must consult appropriate medical professionals for advice in treating any injury or medical problem that you specifically have. This manual is not intended to be a complete or final guide to medical treatment of anyone’s individual medical injury or problem.

Infection is like an extra blocker on the track– it’s unfair and can knock you down without warning. So get the upper hand and penalize the germs.

The skin takes a beating in derby, as you all well know. A wound is bad enough, but because of the dirty environment you often skate in, infection is the greater worry. Infection not only slows the healing and makes a larger scar but can spread to other parts of the body or the blood stream. We worry especially if a skin infection develops near a joint because spread to a joint is very serious. Let’s talk about avoiding infections.

Cleanliness is next to a grand slam. Frequent washing of your body and especially hands keeps the germ count on your skin low. Plain soap and hot water is all you need; antibacterial soaps and sprays are expensive and somewhat over-rated. It’s the washing action that does it. But the antibacterials can be used if hot water is not readily available.

Cleaning your gear will reduce the germs to which you are exposed. What can be washed in hot soapy water should be– often. There are a number of products available that can be used on gear that can’t tolerate soap and water washing. Germs survive less well on dry surfaces– dry your gear out– often. Your mouth guard is part of your gear; clean it every day. Hydrogen peroxide and Listerine® are good for that.

But you know you will get abrasions, cuts, and scrapes. Dealing with them promptly and effectively will keep you from developing infection. Here’s what you can do:

a. After stopping any bleeding with a clean pressure dressing, all wounds should be cleaned of as much bacteria as possible. Again, good old soap and water works well. If that is not easily available, there are a number of sterile saline or anti-bacterial washes (with or without anesthetic) that you can use (such as betadeine or Hurt-Free®). Note: some people are allergic to the topical anesthetics (anything with a name ending in -caine). Although painful, removing debris from the wound is very important. You can do this with a spray bottle of sterile water or by scrubbing the area with a gauze pad.

b. Most wounds should be covered till they heal well, i.e., form a scab. You have less chance of infection, and you are less likely to spread infection. Wounds where the skin has been scraped off are best covered with a non-stick dressing. Adhesive bandages will suffice for most cuts and scratches. As the wound ages (several days), generally the covering should be loose enough to allow air to dry the wound–unless your wound will be exposed to wetness and dirt. If the wound is under equipment such as elbow or knee pads, you may need a more protective closed dressing.

c. Antibacterial ointments are apparently popular. However, in most cases, they aren’t needed; they are expensive; and allergy to the neomycin used in multi-antibiotic ointments is common. If you do use anti-bacterial ointments, a single ingredient one (such as bacitracin) is advised. Simple soap and water washing for a few minutes, 2 – 3 times a day is really preferable. This is true unless you have seen an M.D. and have been advised otherwise.

d. For wet wounds, such as abrasions or blisters, a drying, antiseptic soak is beneficial. Domeboro’s solution® (OTC) is available in packets of powder. One packet dissolved in a quart of hot water 2 – 3 times a day is recommended. You can use this by soaking the wound in a pan of Domeboro’s solution® or by alternating hot compresses. The compress method involves using two clean cloths in the Domeboro solution®, placing one cloth on the wound for a minute, taking it off back into the solution, and replacing it with the 2nd soaking cloth, alternating cloths for about 5 – 10 minutes. This method helps remove dead tissue and debris from the wound surface as well as drying the wound.

e. If a wound develops pus in it, gets an increasingly larger area of redness around it, or gets more painful with time, you should consult your doctor.

f. Infected wounds are contagious mainly by direct contact. If you have an infected wound that is well covered, you are little danger to your teammates.

Roll and rock clean by eliminating the extra blocker.

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