Trench Foot Research Articles

A case of bilateral trench foot

A case of severe bilateral trench foot is presented in a patient who lived rough for 3 weeks without removing his boots. Non-operative management yielded no clinical improvement and bilateral below-knee amputation was necessary. Histology revealed subcutaneous and muscle necrosis with secondary arterial thrombosis.

Efficacy of Antiperspirants on Feet

Nineteen male soldiers participated in a study of the effectiveness of two antiperspirants (aluminum chlorohydrate and aluminum zirconium tetrachlorohydrex glycine) in reducing foot-sweat accumulation and injuries. Each subject was tested before and after antiperspirant application, with a 1-hour treadmill march at 5.6 km/hour in a warm environment. Both antiperspirants decreased (p less than 0.05) foot-sweat accumulation over 50%. There was also a tendency, although not statistically significant, for subjects to incur fewer blisters with antiperspirant use. However, the antiperspirants also increased (p less than 0.05) the incidence of irritant dermatitis. Nevertheless, these data suggest that the application of antiperspirants to the feet has merit in reducing serious foot injuries (blisters, trench foot) exacerbated by wet feet.

Immersion foot. A problem of the homeless in the 1990s

The syndrome of immersion foot is being seen with increasing frequency among the homeless population. It represents the effects of injury by water absorption in the stratum corneum of the skin of the feet. The taxonomy of this disorder is confusing and the many colorful pseudonyms should probably be dropped in favor of a simple classification based on the temperature of the water and the duration of exposure. When uncomplicated by infection or ischemic injury, immersion foot will quickly resolve with conservative measures only. More complicated cases may require antibiotics and surgical treatment. This syndrome may be exacerbated by disturbances of cognition, peripheral neuropathy, peripheral vascular disease, or the use of tobacco or vasoconstrictor drugs such as cocaine. A major contributing factor seems to be lack of shelter in the homeless population. Attention to foot care problems among the homeless and education concerning preventive measures are incumbent on physicians who care for the indigent.

Immersion Foot

The syndrome of<i>immersion foot</i>is being seen with increasing frequency among the homeless population. It represents the effects of injury by water absorption in the stratum corneum of the skin of the feet. The taxonomy of this disorder is confusing and the many colorful pseudonyms should probably be dropped in favor of a simple classification based on the temperature of the water and the duration of exposure. When uncomplicated by infection or ischemic injury, immersion foot will quickly resolve with conservative measures only. More complicated cases may require antibiotics and surgical treatment. This syndrome may be exacerbated by disturbances of cognition, peripheral neuropathy, peripheral vascular disease, or the use of tobacco or vasoconstrictor drugs such as cocaine. A major contributing factor seems to be lack of shelter in the homeless population. Attention to foot care problems among the homeless and education concerning preventive measures are incumbent on physicians who care for the indigent. (<i>Arch Intern Med.</i>1991;151:785-788)

Cold Exposure Injuries: Prevention and Treatment

A variety of cold exposure injuries were discussed, including frostnip, chilblains, trench foot, frostbite, and hypothermia. The usual precipitating factors for each were discussed along with the clinical course, the pathophysiology, and management from the perspective of one being in the field or backcountry. Prevention is the key to all cold-related problems as adequate treatment is often not possible out of the hospital setting. Detailed recommendations were made for all conditions, relative to treatment and prevention, with special emphasis on hypothermia.

Medical Department, United States Army—Internal Medicine in Vietnam, vol 1: Skin Diseases in Vietnam, 1965-72

Two important concepts are documented in this book: (1) Santayana's aphorism Those who cannot remember the past are condemned to repeat it, and (2) significant clinical research can be carried out under military conditions in combat areas. During World War II and in subsequent military campaigns in tropical and subtropical regions, skin diseases have been a major cause of disability. They were the single greatest cause of outpatient visits to US Army medical facilities during the entire Vietnam War, and on occasions in 1967 and 1968, Vietnam combat commanders reported up to 50% of their men were unavailable for duty because of dermatologic problems. The most frequent diseases were pyodermas from streptococci and staphylococci, fungus infections caused by dermatophytes and Candida , and miliaria rubra and immersion foot. Exotic diseases such as leishmaniasis, schistosomiasis, and hirudiniasis were not common. Streptococcal infections—impetigo, ecthyma, and cellulitis—responded best to penicillin (intramuscular benzathine penicillin G

Immersion Foot: A Method for Studying the Effects of Protracted Water Exposure on Human Skin

Immersion Foot: A Method for Studying the Effects of Protracted Water Exposure on Human Skin

Warm Water Immersion Injuries of the Feet – A Review

AbstractWarm water immersion injuries of the feet are of considerable relevance to military operations in tropical and sub-tropical regions.An outline of experience gained during the 1939-45 and Vietnam wars is given.Recently, two distinct warm water immersion injuries have been delineated viz. Warm Water Immersion Foot (WWIF) and Tropical Immersion Foot (TIF), the latter resulting from longer periods of immersion.The current state of knowledge with respect to pathogenesis, clinical features, histopathology, management and prophylaxis, of these two syndromes, is presented.A requirement exists for further study, with emphasis on the pathogenesis and prophylaxis of Tropical Immersion Foot.

TROPICAL IMMERSION FOOT

Tropical-immersion-foot syndrome was studied in U.S. Army units in Vietnam. The principal characteristics were: temporary inability to walk due to painful swollen feet; history of protracted exposure (>72 hours) to relatively warm water (22-32°C); erythema, œdema, and tenderness of the skin covering the ankles and dorsa of the feet; chronic inflammation and vasculitis of the upper dermis, with maceration of the stratum corneum; and pronounced variation in individual susceptibility to immersion injury. Complete healing occurred promptly after drying and elevation of the feet. Tropical immersion foot (T.I.F.) is a different disease from warm-water immersion foot (W.W.I.F.), which is a syndrome characterised by painful, white, wrinkled soles. Evidence suggests that T.I.F. is caused by an effect of water itself on the dermis, whereas W.W.I.F. is due to hyperhydration of the plantar stratum corneum.

Silicone for immersion foot prophylaxis: where and how much to use

Silicone for immersion foot prophylaxis: where and how much to use

Silicone for immersion Foot Prophylaxis: Where and How Much to Use

Silicone for immersion Foot Prophylaxis: Where and How Much to Use

Random Separation - Development and Experience

The joint burial of primary power and telephone distribution cables with no deliberate separation is known as random separation. After extensive tests, the Joint Edison Electric Institute- Bell System Subcommittee to Study Buried Distribution Systems recommended random separation between telephone cables and certain types of primary power cables having bare neutrals in direct contact with the earth and protected by devices capable of clearing faults within prescribed time-current limitations. There has been favorable experience with over 18 million trench feet of random construction serving more than 200 000 dwelling units. The National Electrical Safety Code and state regulations have been revised to permit random separation.

The Role of Temperature in Tropical Immersion Foot Syndrome

Eleven volunteers wore a noninsulated boot on one foot and an insulated rubber boot filled with water on the other foot during 72 hours of immersion in swamps. Both feet were continuously wet, but the temperature of one foot of each man was approximately 20 F (11.2 C) higher than the other throughout the study. Results indicated that symptomatic tropical immersion foot can be produced without any element due to cold injury or heat loss, and that symptoms occurred more rapidly at the higher temperature.

The role of temperature in tropical immersion foot syndrome

The role of temperature in tropical immersion foot syndrome

Prophylaxis of Warm-Water-Immersion Foot

Warm-water-immersion foot has caused a large number of casualties among our troops fighting in Vietnam. A prophylaxis against this condition was studied. A silicone grease was applied to the feet of 52 men every 24 hours. Their feet were exposed to an occlusive, wet environment for five days. Mild or early changes of immersion foot developed in six of the men and all of the subjects completed the test. Six volunteers were exposed to the same wet conditions without using silicone grease; symptomatic immersion foot developed in five of these subjects and four were unable to continue in the test beyond the third day due to the severity of their symptoms.

Peripheral nerve damage by cold.

WE HAVE studied the histological and clinical effects of low temperatures on the sciatic nerve of the cat. A selective effect on small nerve fibers by chemicophysical means has been previously reported by several workers.1,2The possibility that cold might selectively destroy large nerve fibers was suggested by the pathological study of colddamaged nerve by Denny-Brown et al.3In addition, physiological studies during cooling of peripheral nerve by Douglas and Malcolm4showed selective blockage of small fibers. Interest in nerve damage by cold received considerable stimulus during the 1940's as a result of exposure injuries consequent to the war. Blackwood5reported findings in 14 cases of immersion foot, mostly in sailors exposed in open boats. He found that immersion for short duration produced less degeneration of axons and myelin than did more prolonged exposures. Blackwood and Russell6produced degeneration in rat nerves by immersing

A review of immersion foot.

A review of immersion foot.

SYMPATHECTOMY IN THE TREATMENT OF FROSTBITE.

It is our purpose to define as well as possible the role of sympathectomy in the treatment of frostbite and its sequelae. We shall point out some of the problems which have made it difficult to reach unanimity of opinion concerning the place of sympathectomy in the management of frostbite, to present our clinical experiences, and to review the pertinent clinical literature. <h3>The Problem</h3> Evaluation of sympathectomy as an adjuvant in the treatment of frostbite has been difficult for a number of reasons. For one thing, there has been a tendency to consider all of the cold injuries together. Though they have certain features in common, chilblains, frostbite, trench foot, and immersion hand and foot differ from one another with respect to mode of injury, acute manifestations, and sequelae. One cannot assume that they will all respond in the same manner to any given therapeutic measure. Here we are concerned

Arteriography in Cold Injury

The injurious effects of cold injury to a limb vary according to the temperature of the environment and the presence of moisture. Moist cold causes injury at higher temperatures than dry cold. Immersion foot, for example, results from prolonged exposure to cold and damp at temperatures just above freezing, especially with immobilisation and dependency of the extremities. Frostbite is a result of actual freezing of the tissues and occurs after exposure to freezing temperatures. The time necessary to produce the injury is related to the temperature of the environment. Although the mechanism producing the pathological changes is not clearly understood (Abramson, 1956), the general view is that cold produces vasoconstriction with anoxia and damage to the capillaries. If the low temperature is severe enough intravascular thrombosis and crystallisation may occur. The presence of vasoconstriction is deduced from the colour and temperature changes present in the feet. Despite the numerous reports of cold injury to members of the armed forces of the different combatants in World War II and the Korean War we have been unable to trace any record of the arteriographic changes present in the acute stage of the injury. We have recently observed such changes in one case of bilateral cold injury to the feet. A 43-year-old vagrant was admitted in January with marked discoloration of both feet following exposure to cold.

Changes in foot volume and capillary fragility during continuous cold exposure and starvation.

The effects of continuous cold exposure (2 wk. at 60°F) and starvation on foot volume and capillary fragility were studied in six men. The experimental period was preceded and followed by 2-week periods (control and recovery) at 80°F and a caloric intake of 2400 cal. Foot volumes decreased 6.1% in the first 5 hours of cold exposure and remained constant for the remainder of the experimental period. Foot volume was also measured after 3 minutes of elevation of the foot and occlusion of the blood supply. This volume decreased less during the experimental than the preceding or following periods. Capillary fragility decreased slowly during the experimental period and increased in the recovery period. On the third day of recovery, foot volumes were larger than at any other time. For the remainder of recovery, foot volume was the same as the control volume, but there was a greater decrease in volume with foot elevation. The results suggest that there was a constriction of all types of blood vessels during the experimental period while in the recovery period there was apparently a simultaneous dilatation of large blood vessels and a constriction of small ones. One subject had a greatly increased volume of one foot associated with pain and redness during early recovery days. These changes may be indicative of early trench foot or capillary damage. Starvation per se appeared to have no effect on foot volume. Submitted on October 15, 1959