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There are many treatments that have been tried
and sworn to be effective through the years. For example:
1. Preparation H or other hemorrhoid ointments have
been used to reduce tissue swelling and some have a topical anesthetic to
help numb the rip. Good
during competition.
2. Bag Balm which is a veterinary balm applied to cows'
utters because they have a tendency to crack/split. Bag Balm is used to
help treat fresh rips or as a hand conditioner to prevent rips.
3. A small balloon taped over the rip may help. The
friction generated between the bars and the tape causes the balloon to rub
against its inner surfaces and prevents motion between the balloon and the
rip. Technically, not legal, during competition.
4. Tuff Skin (a taping base) sprayed onto a fresh rip,
has been reported to STING! but is supposed to help heal rips (not
recommended, but may get you through the meet!).
5. Another torture treatment that STINGS a great deal is
soaking the freshly ripped hand in a 10 percent bleach in water solution
(not recommended).
6. The old standby of covering the hands with a hand
lotion, vitamin E, or aloe vera at night while sleeping and protecting the
bed sheets by wearing gloves or socks over the hands. Please, use a
non-perfumed hand lotion since the perfume is alcohol based and will
STING.
7. Gibson (1–800–275–5999) sells DAT Sticks which is a
series of three balms: a callous stick used prior to workouts to promote
toughening of calluses, a condition stick which is used at night to keep
calluses smooth and pliable, and a rip stick used to help heal fresh rips.
8. The company, 10.0 (1–800–241–9249), sells Spenco “Rip
Kits” which contains “2nd Skin” (a hydrogel dressing) to help with fresh
rips and to help prevent and protect rips. The kit also contains pressure
foam pads and adhesive knit. 10.0 also sells a “skin freeze” which is a
spray that will cool down hot hands to reduce skin irritation.
9. Dunlap makes a skin protector called “Compeed” which
can be used in training to protect the fresh rip and also helps to heal
these rips. This can be found in many sporting goods stores and bicycle
shops.
10. Neoprene rubber hand grips(Grippers) prevent rips.
11. G.A. Deitch (717–697–3107) makes a lanolin protective
glove which is worn underneath the regular grip as a "undergrip".
12. Of course the tape grip made out of white trainer's
tape to protect a rip is a standard but I recommend using Johnson &
Johnson Elastikon elastic tape instead.
13. Trimming calluses (with a “Pyrex Corn and Callus
Shaver”) is important to help prevent rips from occurring.
14. DuoDERM and Nova Derm sterile occlusive dressings and
Op-sight and Bioclusive transparent moisture vapor permeable
hypoallergenic viral barriers
Recommended treatment for rips
Prevention of infection is the
first thing that must be considered when treating a rip. I have seen
improperly treated rips develop cellulitis (blood poisoning) and required
intravenous (IV) antibiotics for treatment of the wound. To prevent this
from occurring the most important thing to do after a rip occurs is to
wash the hand with warm water and a mild soap. The latest medical research
shows that soap and warm water is more effective in treating wounds than
using Betadine (povidone iodine) or hydrogen peroxide. Hydrogen peroxide
should no longer be used as a general wound cleaner unless recommended by
a physician for a specific wound. It has been determined that hydrogen
peroxide is too caustic for the wound and destroys healthy cells and can
actually delay healing. Betadine has also been shown to be too strong and
can damage cells when applied to a wound. Betadine is still used as a
pre-operation skin preparation (to clean the skin before it is cut open)
and is used for cleaning wounds in the Emergency Room prior to suturing
lacerations but the Betadine is watered down with sterile water and is
rarely used with out being watered down. The most effective way of
cleaning wounds is by irrigating well with water and washing with warm
soapy water.
Once the rip has been washed and
dried well to prevent infection then a sterile bandage should be applied.
The type of sterile bandage is dependent on the severity of the rip and
the amount of money available for treating the wound. The inexpensive way
of treating minor rips is by applying a triple antibiotic ointment
(Neosporin) to a sterile bandage and covering the wound with this bandage.
When this bandage becomes wet it should be changed.
The most effective way to speed
up the healing process is to utilize the expensive bandage protocol. After
the wound has been cleaned by soapy water and dried, a DuoDERM Extra Thin
CGF Spot dressing is applied to the wound. DuoDERM dressings have a skin
contact adhesive layer containing hydroactive particles that interact with
fluid produced by the wound. This forms a moist gel which provides a great
environment for cell migration, leading to rapid healing. Because of this
environment, you should not add a triple antibiotic ointment (Neosporin)
to the wound when DuoDERM is used as a dressing since it may actually
delay healing. Some studies (Xakellis and Chrischilles) have shown a 46
percent faster healing rate than with gauze bandages. This moist gel which
protects the wound from re-injury when the dressing is removed. With gauze
bandages the wound dries out and sticks to the dressing and can tear away
newly formed tissue when the bandage is removed (Tudhope).This, of course, is to be done AFTER competition is
completed!
DuoDERM Dressings present a
functional barrier to external contamination with infection rates up to
five times lower than with gauze bandages (Hutchinson). It can be left on
for as long as seven days in a row before needing to be changed. The
athletes may wash their hands and even shower and keep the dressing in
place. With the Extra Thin DuoDERM you can even lift light bars with the
bandage held in place by tape beneath the grip. However, some athletes
prefer to use an even thinner viral barrier called Bioclusive or Op-sight
while swinging bars. It is my recommendation that after use on bars the
dressing should be changed no matter what type is used.
DuoDERM is currently be used by
many collegiate and professional sports medicine staffs for their athletes
in a variety of sports. These facilities, however, have the resources to
purchase the dressings. The way to help reduce this cost is to have a
physician write a prescription for the DuoDERM. Ask the physician to put
several refills on the prescription so that more DuoDERM can be used when
the gymnast rips again in the future. Since many medical insurance
companies cover the use of DuoDERM the only cost to the athlete is the
prescription co-pay. DuoDERM is available over the counter at many
pharmacies. The best way to find it is to go to a pharmacy connected to a
hospital or one which sells hospital supplies. Remember the extra-thin
type of DuoDERM is the type to use.
No matter what type of dressing
you use to cover the wound signs of infection need to be assessed. These
signs of infection include: a foul order, pus or yellowish discharge
(exudate), redness (erythema), and fever. If these signs develop the wound
should be evaluated by a physician for further cleaning and the use of
antibiotics.
References
1. Hutchinson J.J. Prevalence of
wound infection under occlusive dressings: A collective survey of reported
research. Wounds. 1989; 1:123–124.
2. Tudhope M. Management of
pressure ulcers with a hydrocolloid occlusive dressing. J of Enterostomal
Therapy. May/June 1984; II:102–105.
3. Xakellis G.C. and Chrischilles
E.A. Hydrocolloid versus saline-gauze dressings in treating pressure
ulcers: A cost-effectiveness analysis. Arch Phys Med
Rehabil. May 1992; 73:463–469.
This article appears in the October 1995 issue of
Technique, Vol. 15, No. 8, p. 14.
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