Trench foot: Difference between revisions

Revision as of 15:15, 25 August 2015

Considered a nonfreezing cold injury
- occurs when ambient temperature above freezing
Develops slowly over hours-days when foot is exposed to cold/wet conditions
Reversible injury may progress to irreversible injury
rarely seen in civilians; significant problem in military operations ^[1]

Initial signs and symptoms
- Numbness and tingling
- Pale, mottled, anesthetic, pulseless, and immobile foot
- No changes will occur after initial rewarming
Hours after rewarming
- Hyperemic phase
- Severe burning pain and reappearance of proximal sensation
2-3 days post treatment
- Edema and bullae may form as perfusion returns
Weeks later
- Anesthesia persists and may be permanent
- Tissue sloughing and gangrene may occur
Months to years
- Hyperhidrosis and cold sensitivity may persist
- Some will have permanent disability

↑ Ikaheimo T. Frostbite and Other Localized Cold Injuries. In: Tintinalli's Emergency Medicine: A comprehensive study guide. 7th ed. McGraw Hill Medical; 2011: 1331

Authors:

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 ==Clinical Features==
-*Tingling/numbness is initial symptom
+*Initial signs and symptoms
-*Foot appears pale, mottled, anesthetic, pulseless, and immobile
+**Numbness and tingling
-**Initially does not change after rewarming
+**Pale, mottled, anesthetic, pulseless, and immobile foot
-*Hyperemic phase begins w/in hr after rewarming
+**No changes will occur after initial rewarming
-**Assoc w/ severe burning pain and reappearance of proximal sensation
+*Hours after rewarming
-*As perfusion returns to foot over 2-3d edema and possibly bullae may form
+**Hyperemic phase
-*Anesthesia persists for weeks and may be permanent; gangrene may occur
+**Severe burning pain and reappearance of proximal sensation
+*2-3 days post treatment
+**Edema and bullae may form as perfusion returns
+*Weeks later
+**Anesthesia persists and may be permanent
+**Tissue sloughing and gangrene may occur
+*Months to years
+**Hyperhidrosis and cold sensitivity may persist
+**Some will have permanent disability
 ==Differential Diagnosis==