The most important thing about abrasions is to keep them from scabbing. Scabs made sense from an evolutionary point of view since they limit protein and fluid losses which is important if these things are difficult to come by. Since modern man can stop at McDonald's and fill all those needs, scabs no longer work so well for us. When a wound heals it is in part because the skin cells slide in to cover the opening. If there is a scab then this is inhibited and wound healing is delayed. Dressing materials also promote wound healing by increasing the temperature locally at the wound site, something that has been experimentally demonstrated to speed wound healing.

Tegaderm. There are many other brands of semi-permeable membrane dressings and they all work more or less as well. The way I use it is to first make sure that the wound is clean and dry. This means that the bleeding needs to have stopped. Usually I will clean the abrasion first with saline and a surgical scrub brush and then cover it with Vaseline, gauze and an absorbent dressing. This is what the OBRA first aid providers will do at the bike race. At some point several hours to a day later I will wash the wound again with soap and saline (or just water) and then apply the semi-permeable dressing. First I paint around the wound with Mastisol or tincture of benzoine. These are products that make the skin sticky so the Tegaderm (or whatever brand you use) will stick to the skin around the wound better. Be careful not to get this stuff in the actual abrasion because it will sting like mad. I then take a Q-tip and some greasy stuff, like Vaseline, and draw a line of grease from the middle of the abrasion to the most dependant part. This line of grease will keep the Tegaderm from sticking at that point and will allow the fluid that comes out of the wound to drain out. The Tegaderm then goes over the abrasion. If the abrasion is too big to be covered by one piece you can overlap the pieces to get it covered. It is important that the Tegaderm extends out over about an inch of intact skin. Now cover at least the opening of the drain created by the grease with an absorbent dressing to catch the goo that will come out of the wound. If you place the dressing this way you can usually leave the Tegaderm on for 4-7 days. Obviously the absorbent dressing should be changed when soiled but the Tegaderm stays in place and you can exercise and shower with it in place. Remove the Tegaderm if you start to see red spots around the wound. The red spots are infection focuses at the hair follicles. Usually this will clear up if the Tegaderm is left off for a day or so.