Trench foot

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Background

  • Develops slowly over hours-days when foot is exposed to cold/wet conditions
  • Reversible injury may progress to irreversible injury

Clinical Features

  • Tingling/numbness is initial symptom
  • Foot appears pale, mottled, anesthetic, pulseless, and immobile
    • Initially does not change after rewarming
  • Hyperemic phase begins w/in hr after rewarming
    • Assoc w/ severe burning pain and reappearance of proximal sensation
  • As perfusion returns to foot over 2-3d edema and possibly bullae may form
  • Anesthesia persists for weeks and may be permanent; gangrene may occur

Treatment

  • Keep feet clean, warm, dryly bandaged, elevated
  • Monitor for signs of infection