Friction Burns: Defining the Rub of Road Rash after Motorcycle Trauma

Abstract There is a paucity of literature on friction burn epidemiology, injury characteristics, and management after trauma. This study aims to characterize friction burns resulting from motorcycle accidents, evaluate the role of specialized burn surgery teams, and assess the need for operative intervention. The trauma registry of a Level 1 Trauma Center was queried for all admissions after motorcycle accidents between January 2018 and December 2022. Patients were included if there was an external cause of injury code for an abrasion. Chart review was conducted to confirm a road rash injury, identify burn consultation, wound care recommendations, need for operating room (OR) procedure and skin grafting, and outcomes. Among the 810 patients meeting inclusion criteria, the cohort was 92% male, 46% Hispanic, with median age of 33 (IQR 26-44), and median ISS 8 (IQR 5-14). The extremities were most affected by friction burn followed by the abdomen, thorax, and face. Burn surgery was consulted in 7% (n=57) of cases which had a median TBSA of 4% (IQR 2-6%); 23% (n=13) of these patients underwent excision in the OR, 16% (n=9) required autografting, and 61% (n=35) were referred for burn follow-up on discharge. On multivariable regression, consults to burn were more likely in female patients (OR 3.40, p=0.002) and those with involvement of the upper extremity, abdomen, or thorax. Friction burns are common after motorcycle-related trauma. Local wound care is sufficient for a vast majority of these injuries and the need for specialized burn care and operative intervention is rare.