Trench foot
Trench foot | |
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Other names | Immersion foot |
Trench foot as seen on an unidentified soldier during World War I | |
Specialty | Emergency medicine, podiatry |
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Complications |
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Causes |
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Treatment |
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Trench foot, also known by
Trench foot occurs due to prolonged exposure of the feet to cold, damp, and often unsanitary conditions.[1] Unlike frostbite, trench foot usually occurs at temperatures above freezing,[1] and can be classed as a form of non-freezing cold injury.[3] Onset can be as rapid as 10 hours.[1] Risk factors include overly tight boots and not moving.[4] The underlying mechanism is believed to involve constriction of blood vessels resulting in insufficient blood flow to the feet.[1] Diagnosis is based on symptoms and examination.[1]
Prevention involves keeping the feet warm, dry, and clean.[1] After the condition has occurred, pain medications may be required during the gradual rewarming process.[1] Pain may persist for months following treatment.[4] Surgery to remove damaged tissue or amputation may be necessary.[1]
Those in the
Names
Trench foot was an informal name applied to the condition from its prevalence during the trench warfare of World War I.[1] Health officials at the time used a variety of other terms as they studied the condition, but trench foot was eventually formally sanctioned and used.[2] Informally, it was also known as jungle rot during the Vietnam War.[5]
It is also known as immersion foot syndrome[6] and as a nonfreezing cold injury.[2]
Signs and symptoms
Trench foot frequently begins with the feeling of tingling and an
Advanced trench foot often involves
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 damage of the surrounding flesh.[7] Excessive sweating (hyperhidrosis) has long been regarded as a contributory cause. Unsanitary, cold, and wet conditions can also cause trench foot.[8]
Diagnosis
The diagnosis of trench foot does not usually require any investigations unless an underlying
Prevention
Trench foot can be prevented by keeping the feet clean, warm, and dry.[1]
Treatment
Keeping the feet dry is the first line treatment. The initial aim is to protect undamaged tissue of the feet and prevent any further destruction of the feet.
The mainstay of treatment—as with gangrene—is surgical debridement. Severe cases may require amputation.[1]
Self-treatment consists of changing socks two or three times a day and usage of plenty of
History
Trench foot was first reported in 1812 by the French army surgeon Dominique Jean Larrey when Napoleon’s army was retreating from Russia.[1][9] It was also a problem for soldiers engaged in trench warfare during World War I, particularly during the winters.[1] Official statistics put the casualty figure for the condition at around 75,000 for the British and 2,000 for the Americans.[2] Amputation was avoided if at all possible and the incidence of trench foot had greatly reduced by the winter of 1917–1918 through improvements to the trenches, modification of soldiers' footwear, and the provision of greases—chiefly whale oil[10]—to prevent damage from excess moisture.[2] It was also discovered that a key preventive measure was regular foot inspections. Rather than leave each soldier to his own devices, they were all paired and each partner made responsible for the feet of the other. As a team, they were more likely to go to the trouble of actually removing their boots and socks, to check for any damage, and to begin treatment at an earlier stage of damage.[10] Trench foot reappeared in the US Army during the Vietnam War in the 1960s and 1970s[5] and in the British Army during the 1982 Falklands War.[1][11] It has been reported among Ukrainian soldiers in 2022 amid the Russian invasion of Ukraine.[12]
Aside from soldiers, the condition has been documented in
See also
- Chilblains
- Trench fever
- Tropical ulcer, also known as Jungle Rot
References
- ^ PMID 29493986
- ^ PMID 17219792.
- ^ Zafren, Ken. "Nonfreezing cold water (trench foot) and warm water immersion injuries". uptodate.com. Retrieved 28 November 2021.
- ^ ISBN 978-0-7817-7332-4.
- ^ a b c Freels, Nicole (7 August 2013), "Can You Still Get 'Trench Foot' Today?", Official site, Lexington: Lexington Podiatry.
- ^ S2CID 163167047.
- ^ ISBN 978-0-323-07242-7
- PMID 14830094.
- PMID 15617178.
- ^ a b David, Saul (presenter) (February 2012). Bullets, Boots and Bandages (episode 1/3). BBC Four.
- ^ Thompson, Julian (18 September 2014). "Falklands Conflict Gallery By Major General Julian Thompson". BBC. Retrieved 10 March 2018.
- ^ "Power cuts and trench foot: winter bites on Ukraine's Donbas front". France 24. Agence France-Presse. 24 November 2022. Retrieved 13 August 2023.
- ^ Sully, Andy (23 June 2008). "I got trench foot at Glastonbury". BBC News. Retrieved 26 May 2010.
- ISBN 978-1-4725-1324-3.
- ^ Morales, Rick; et al., "The Essential Guide to Jungle Foot Care", Official site, Bristol: Secret Compass.
External links
- Media related to Trench foot at Wikimedia Commons