We are very big on turf burn injuries. They can linger, they can be very painful and can cause a lot of underlying damage. Skin can take forever to heal if not treated properly. Scarring is a major concern, especially for our female athletes. As more and more colleges and high schools move to turf, we will see these injuries more often and need to know how to treat them quickly and effectively, and get our athletes back on the field.
Read our previous Turf Burn Treatment article for good background information.
Here is a case of a soccer player that was sent to me. He was playing soccer on an indoor field and slid to save a ball from going out of bounds. He suffered a severe case of turf burn. One of the worse I have ever seen. The back of his leg from his mid thigh to his buttock was all red, raw, and had missing skin layers. The area was large and nearly 8 X 8 inches in size. The underlying tissue was damaged as well and he had a lot of swelling, bruising, and tenderness to his entire leg, even on the front of his leg. He was sent to me 2 days after the initial injury occurred.
What we see with turf burn is just the tip of the iceberg. The tissue underneath is usually severely damaged and injured. Blood vessels have ruptured and inflammatory processes have begun.
Here is a picture pre-treatment injury and then the picture below this is how we dressed and treated the turf burn injury. You can see the massive amount of missing tissue. You can also see that the area has been prepped. We used a trimmer to clip hairs surrounding the area down to a minimum, mainly to allow the tegaderm to stick well and seal completely on the skin. The wound was cleaned and sprayed with one of those “no burn” antiseptic and analgesic sprays. Band-Aid makes a nice one. Don’t use anything that is toxic to the tissue or will cause tissue damage and tissue death like alcohol, peroxide, iodine, betadine, chlorhexadine, etc. Either clean it with lots of normal saline, or one of these mild antiseptic/analgesic sprays. We started with just the normal sailne, but he was in so much pain and it was burning so much, that we had to switch and spray on the analgesic first.
Tegaderm can be bought at Walgreens or any pharmacy and was applied to the area sealing it in. Leave it on for 7 days. Change it on day 7. Shave off more hair. Leave it on another 7 days. We left this one on for 11 days straight and didn’t change it. The wound should be completely healed by then with no signs of scar or skin damage. You can shower, swim, and do your normal activities with Tegaderm in place. It seals in the wound and allows for the skin and damaged tissue to breathe through the membrane.
The underlying bruised and damaged tissue (the hematoma) can be treated with the usual protocol for large bruises (ice, heat, elevation, rest).
Here are some more pictures from the wound and it’s progression in healing.
The above is the initial dressing of Tegaderm placed 2 days after the injury. There was some delay, but the results were spectacular nonetheless.
After ten days, many parts of the skin had healed and a layer of dry skin had already started sloughing off and sticking to the tegaderm. In the above picture, you can see the crusty yellowish/brown sections that are crusted over dry skin underneath.
This picture was taken at exactly 2 weeks. The tegaderm was removed on day 11. (we left it on and didn’t change it at all). You can see that the skin has healed completely and reepithelialized with no scarring and minimal noticeable damage. This was healed completely in 2 weeks with no scarring an no ill effects of skin weakness, scabs, or poor healing.
As you can see, with proper and prompt treatment, a large are of rug burn or turf burn can be treated easily and successfully without any sequelae of the burn injury. Make sure you treat all your athletes this way and don’t delay treatment!