Trench foot

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  • 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]

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

Differential Diagnosis

Foot diagnoses



Cold injuries


  • Usually clinical


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

See Also


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