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Trench foot

Trench foot is marked by ulcers, blisters on the feet when it is kept exposed to unsanitary conditions for long time. Very often trench foot develops on people who work constantly on wet or damp environment. Is it is one of the syndromes that belong to “immersion foot syndrome”. This disease was first noticed on the soldiers of World War I who were badly affected on their feet due to prolonged exposure to moist conditions without wearing waterproof boots. This disease is quite common on cold weather and rainy days.

Many British soldiers were forced to keep their feet immersed in waterlogged ditches where they were asked to stand for hours together. This would seriously affect the normal blood flow on their feet and cause numbness and in serious cases the entire feet has to be amputated. It was reported that more than 20,000 soldiers were treated for trench foot. Due to this condition the foot gets infected turning into red color due to erythrosis or blue color due to Cyanosis. The feet develops stench due to continuous exposure to moisture and when the conditions become worse or left untreated it begins to swell. In advanced stage trench foot develops blisters or ulcerous growth leading to gangrene.

Causes :

The main cause for trench feet is exposing the feet to moisture or wet conditions for prolonged time. It can also be caused due to exposure of feet on unsanitary water or cold conditions. Hours of exposure to wetness will cause itchiness and rash formation on the skin which in turn will promote bacterial growth causing tissue damage. If left untreated this condition will lead to ulcer or blisters or sometimes causes gangrene leading to amputation of the feet.

The trench foot does not develop overnight. It occurs slowly on three stages :-

In the first stage, the blood vessels of the foot get constricted by water and moisture. There will not any oxygen for the foot cells to breathe since the entire foot becomes drenched with water. The foot will be cold and looks little swollen and there can be numbness on certain areas indicating cutting off blood supply. The discomfort or numbness will be removed if the foot is taken out of water and re-warmed. There will be sensitivity on the foot once it is removed from water surface or warming up with hands.

In the second stage the cells of the foot get affected since there will not be any blood flow. This in turn causes the blood vessels to open up which leads to swelling of foot due to accumulation of fluid inside. There will be tingling sensation and sharp pain that would not go even after the foot is removed from water. For some people ulcers or blisters are formed in this stage which will eventually fall off exposing the underlying tissue. There will be severe discomfort with pain for 2-6 weeks but the foot can be cured completely with medications.

In the final stage there will be intense swelling and pain and the foot will take months together to get back to normalcy. There will be sweating of foot and it become sensitive to cold. Due to overgrowth of bacteria and ulcers it becomes difficult to cure the feet leading to amputation.

Symptoms :

There will be burning sensation, intense pain and tingling sensation on the foot depending on the duration for which it is kept under water. For some there will be loss of feeling or numbness and the foot becomes cold and blotchy. The color of the foot will turn blue or red and will have a heavy feeling. Blisters or ulcers are formed in the last stage and it would fall off exposing the underlying tissue or skin. The symptoms can range from mild to severe and the signs can involve only the toes or heel or even on the entire foot.

Pictures of Trench Foot :

Images, Pics, Pictures and Photos of Trench Foot

Treatment :

Firstly you need to reduce the exposure of your feet in water or unclean liquids for prolonged time. You should provide dry environment and space for breathing inside the shoes. Avoid standing for extended hours in water and whenever possible remove your socks and warm-up your feet to become dry. Keep the feet thoroughly dry by removing excess of moisture.

For people who are sweating more it is necessary to change the socks twice daily and the feet should be air-dried to remove moisture. Do not wear synthetic or rubber footwear which will retain moisture for long time.

For mild infection or during the first stage of trench foot cleansing lotions can be used for cleaning the feet thoroughly. Wipe the feet with clean towel and allow it to dry completely. Keep the foot elevated for some time to promote blood flow. Warm water therapy for the affected foot is highly useful for rejuvenating the cells and for removing dead cells from the trench foot.

After taking bath, you can apply talcum powder on your feet to prevent moisture. Keep your feet in lukewarm water daily for 5-10 minutes which is the best therapy for pain. After getting back home remove your socks and keep the feet airy.

Once you see blisters or ulcerous growth on the feet it is necessary to consult your doctor to prevent bacterial infection. For people who are diabetic they must check the feet regularly for wounds or any cuts. Aluminum chloride is widely used in topical ointments as drying agent. Antihistamine is prescribed for reducing pain and controlling infection.

For severe case of trench foot infection surgery is the best choice. Botox injection is taken commonly by many people for paralyzing the muscle to produce sweat on the foot so that perspiration on the feet can be controlled. Surgical anhydrosis is done for removing the dorsal root ganglion to stop foot sweating completely.

Trench foot – Pictures, Symptoms, Causes, Treatment, Cure

What is Trench foot?

This is a medical problem of the feet which develops after prolonged exposure to unsanitary, damp as well as cold conditions. It also is one of the many syndromes which are referred to as “immersion foot syndromes”. The name “trench” is used as a reference to the trench warfare, normally associated with World War I.

This problem with the feet developed in many soldiers while fighting in the First World War. This infection of the feet developed by wet, cold and insanitary conditions in waterlogged trenches which soldiers stood for hours in unable to take off the wet socks or boots. This would gradually cause the feet to go numb as well as the skin would turn blue or red. Left untreated, trench foot often turned gangrenous and resulted in many amputations. During the winter of 1914-1915 there were over 20,000 soldiers in the British Army treated for this condition.

With this condition, the infected feet become numb, developing erythrosis which turns the feet red or Cyanosis which turns the feet blue because of a terrible vascular supply. The feet could begin to have the stench of decay due to the early phases of necrosis setting in. When the conditions get worse, the feet can also start to swell. Trench foot in advanced stages often has open sores as well as blisters which can lead to fungal infections. This stage is often called topical ulcer or jungle rot.

When not treated, trench foot normally results in gangrene, which can eventually lead to foot amputation. If this condition is properly treated, a complete recovery is normal, although it can be marked by short-term severe pain as the feeling in the feet returns.

Trench foot Causes

Trench foot is divided into 3 stages. This first one is the time when the blood vessels are constricted by cold and wetness inside the boot or shoe with too little oxygen getting to the foot cells. The foot becomes cold to the touch, a little swollen, discolored slightly, numb, as well as a little tender to the touch. If the foot is re-warmed at this stage, the damaged tissue normally appears red and feels sensitive. This discomfort can last from days to only hours.

Stage two is the time when the foot cells become damaged by the lack of good circulation. When the blood vessels open up, the tissue swells with excess fluid. Individuals complain of pain which is tingling that never goes away. There is more swelling. Upon re-warming, blisters form and then ulcers where the blisters fall off revealing tissue which is dead underneath. In some severe cases, gangrene will result. Suffering can last from 2 to 6 weeks and drugs for pain are prescribed.

Stage three may last for weeks or months. Swelling subsides and the foot starts to look normal again. During this stage, the individual can complain of increased sweating of the foot, increase cold sensitivity, as well as varying degrees of itching, pain as well as creeping, tingling, prickly feeling.

Trench foot Symptoms

Tingling and/or itching sensation

Burning sensation

Loss of feeling

Pain

Swelling

Cold and blotchy skin

Numbness

Foot can appear cyanotic (gray)

Prickly or heavy feeling

Foot is dry, red as well as painful after warming

While warming burning can be severe

Fissures as well as maceration of the skin is common

Blisters

Skin as well as tissue dying and falling off

Can involve heel, toes, and entire foot

Trench foot Treatment

Prevention is the key in treating this condition. Limit exposure to cold is very important in stopping as well as treating trench foot. It is a must to maintain a dry environment inside the shoe. Controlling any excessive perspiration will help.

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When exposed to wet and cold condition, the feet when possible should be air-dried and elevated and there should be an exchange of wet socks and shoes for dry ones so that trench foot does not begin to develop.

The treatment for this condition is very close to the treatment for frostbite. The following steps should be taken:

Clean and dry thoroughly the feet

Avoid synthetic type materials such as vinyl or rubber

Wear cloth or leather which can absorb moisture

Use dry, clean socks daily

Use baby powder or talc to keep moisture away

Affected area should be treated by applying warm packs or socking in warm water – 102 degrees to 110 degrees for about 5 minutes.

While resting or sleeping, do not wear socks

Medical assistance should be obtain as quickly as possible

If the feet have any wounds, they will become very prone to infection. The feet should be checked daily for worsening of symptoms or signs of infections.

Drying agents are helpful to control moisture. Aluminum chloride is the agent most commonly used in the tropics. Formalin is used as well in other prescription medications. Antihistamine an anticholinergic medications should be used in severe cases. These drugs include Banthine, Benadryl or Pro-Bathine.

Where there are severe cases of feet sweating, it can also be treated with surgery as well as injections. Recently, Botox injections have been successfully by dermatologists and podiatrists. Botox is used to paralyze the smooth muscle which regulates the sweat glands on the bottom of the foot.

An endoscopic excision of the dorsal root ganglion is another method used by neurosurgeons to create an environment of surgical anhydrosis – absence of perspiration – by removing surgically the component of the nervous system that is responsible for autonomic functions such as perspiration.