Trench foot

Trench foot is a medical condition caused by prolonged exposure of the feet to damp, unsanitary, and cold conditions. It is one of many immersion foot syndromes. The use of the word trench in the name of this condition is a reference to trench warfare, mainly associated with World War I.

Trench foot
Other namesimmersion foot
Trench foot as seen on an unidentified soldier during World War I
SpecialtyEmergency medicine

Signs and symptoms

Affected feet may become numb, by erythema (turning red) or cyanosis (turning blue), as a result of poor blood supply, and may begin emanating a decaying odor if the early stages of necrosis (tissue death) set in. As the condition worsens, feet may also begin to swell. Advanced trench foot often involves blisters and open sores, which lead to fungal infections; this is sometimes called tropical ulcer (jungle rot). If left untreated, trench foot usually results in gangrene, which may require amputation. If trench foot is treated properly, complete recovery is normal, although it is marked by severe short-term pain when feeling returns.[1]

Causes

Unlike frostbite, trench foot does not require freezing temperatures; it can occur in temperatures up to 16 °C (61 °F) and within as little as 13 hours. Exposure to these environmental conditions causes deterioration and destruction of the capillaries, and leads to morbidity of the surrounding flesh.[2] Excessive sweating (hyperhidrosis) has long been regarded as a contributory cause; unsanitary, cold, and wet conditions can also cause trench foot.[3]

Prevention

Trench foot can be prevented by keeping the feet clean, warm, and dry. It was also discovered in World War I that a key preventive measure was regular foot inspections; soldiers would be paired and each partner made responsible for the feet of the other, and they would generally apply whale oil to prevent trench foot. If left to their own devices, soldiers might neglect to take off their own boots and socks to dry their feet each day, but when it was made the responsibility of another, this became less likely.[4]

Treatment

The mainstay of treatment, like the treatment of gangrene, is surgical debridement, and often includes amputation. Self-treatment consists of changing socks two or three times a day and usage of plenty of talcum powder. Whenever possible, shoes and socks should be taken off, the feet bathed for five minutes and patted dry, talcum powder applied, and feet elevated to let air get to them.

History

Trench foot was first documented by Napoleon's army in 1812. It became prevalent during the retreat from Russia and was first described by the French army surgeon Dominique Jean Larrey.[5] It was also a problem for soldiers engaged in trench warfare during the winters of World War I (hence the name).[6]

Trench foot made a reappearance in the British Army during the Falklands War, in 1982.[7] Some people were even reported to have developed trench foot at the 1998 and 2007 Glastonbury Festivals,[8] the 2009 and 2013 Leeds Festivals, as well as the 2012, 2016, and 2019 Download Festivals, as a result of the sustained cold, wet, and muddy conditions at the events.

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See also

References
  1. Schwartz, Richard B. (2008). Tactical Emergency Medicine. LWW medical book collection. Lippincott Williams & Wilkins. p. 319. ISBN 9780781773324. Retrieved 2016-12-11.
  2. Coughlin, Michael J.; Saltzman, Charles L.; Mann, Roger A. (2013), Mann's Surgery of the Foot and Ankle (9th ed.), Elsevier Health Science, p. 2336, ISBN 9781455748617, retrieved 2016-12-11
  3. "CHRONIC TRENCH FOOT: A STUDY OF 100 CASES". Annals.org. 1951-05-01. Retrieved 2011-10-20.
  4. David, Saul (presenter) (February 2012). Bullets, Boots and Bandages (episode 1/3). BBC Four.
  5. Régnier C (2004). "Etiological argument about the Trench Foot". Hist Sci Med (in French). 38 (3): 315–32. PMID 15617178.
  6. Atenstaedt, RL (2006). "Trench foot: the medical response in the first World War 1914-18". Wilderness Environ Med. 17 (4): 282–9. doi:10.1580/06-WEME-LH-027R.1. PMID 17219792.
  7. "Falklands Conflict Gallery By Major General Julian Thompson". BBC. 2014-09-18. Retrieved 2018-03-10.
  8. "I got trench foot at Glastonbury". BBC News. June 23, 2008. Retrieved May 26, 2010.
Classification
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