Trench foot
Encyclopedia
Trench foot is a medical condition caused by prolonged exposure of the feet to damp, unsanitary, and cold conditions. It is one of many immersion foot syndromes
Immersion foot syndromes
Immersion foot syndromes include:* Trench foot* Warm water immersion foot* Tropical immersion foot...

. The use of the word "trench" in the name of this condition is a reference to trench warfare
Trench warfare
Trench warfare is a form of occupied fighting lines, consisting largely of trenches, in which troops are largely immune to the enemy's small arms fire and are substantially sheltered from artillery...

, mainly associated with World War I
World War I
World War I , which was predominantly called the World War or the Great War from its occurrence until 1939, and the First World War or World War I thereafter, was a major war centred in Europe that began on 28 July 1914 and lasted until 11 November 1918...

.

Characteristics

Affected feet may become numb, affected by erythrosis (turning red) or cyanosis (turning blue) as a result of poor vascular supply, and feet may begin to have a decaying odour due to the possibility of the early stages of necrosis
Necrosis
Necrosis is the premature death of cells in living tissue. Necrosis is caused by factors external to the cell or tissue, such as infection, toxins, or trauma. This is in contrast to apoptosis, which is a naturally occurring cause of cellular death...

 setting in. As the condition worsens, feet may also begin to swell. Advanced trench foot often involves blister
Blister
A blister is a small pocket of fluid within the upper layers of the skin, typically caused by forceful rubbing , burning, freezing, chemical exposure or infection. Most blisters are filled with a clear fluid called serum or plasma...

s and open sores, which lead to fungal
Fungus
A fungus is a member of a large group of eukaryotic organisms that includes microorganisms such as yeasts and molds , as well as the more familiar mushrooms. These organisms are classified as a kingdom, Fungi, which is separate from plants, animals, and bacteria...

 infections; this is sometimes called tropical ulcer
Tropical ulcer
Tropical ulcer is a lesion occurring in cutaneous leishmaniasis. It is caused by a variety of microorganisms, including mycobacteria...

 (jungle rot).

If left untreated, trench foot usually results in gangrene
Gangrene
Gangrene is a serious and potentially life-threatening condition that arises when a considerable mass of body tissue dies . This may occur after an injury or infection, or in people suffering from any chronic health problem affecting blood circulation. The primary cause of gangrene is reduced blood...

, which can cause the need for amputation
Amputation
Amputation is the removal of a body extremity by trauma, prolonged constriction, or surgery. As a surgical measure, it is used to control pain or a disease process in the affected limb, such as malignancy or gangrene. In some cases, it is carried out on individuals as a preventative surgery for...

. If trench foot is treated properly, complete recovery is normal, though it is marked by severe short-term pain when feeling returns. As with other cold-related injuries, trench foot leaves sufferers more susceptible to it in the future.

Causes

Trench foot occurs when feet are cold and damp while wearing constricting footwear. Unlike frostbite
Frostbite
Frostbite is the medical condition where localized damage is caused to skin and other tissues due to extreme cold. Frostbite is most likely to happen in body parts farthest from the heart and those with large exposed areas...

, trench foot does not require freezing temperatures and can occur in temperatures up to 60° Fahrenheit
Fahrenheit
Fahrenheit is the temperature scale proposed in 1724 by, and named after, the German physicist Daniel Gabriel Fahrenheit . Within this scale, the freezing of water into ice is defined at 32 degrees, while the boiling point of water is defined to be 212 degrees...

 (about 16° Celsius
Celsius
Celsius is a scale and unit of measurement for temperature. It is named after the Swedish astronomer Anders Celsius , who developed a similar temperature scale two years before his death...

). The condition can occur with as little as eleven hours' exposure. The mechanism of tissue damage is not fully understood. Excessive sweating or hyperhidrosis
Hyperhidrosis
Hyperhidrosis is the condition characterized by abnormally increased perspiration, in excess of that required for regulation of body temperature.-Classification:Hyperhidrosis can either be generalized or localized to specific parts of the body...

 has long been regarded as a contributory cause.

Prevention

Trench foot is easily prevented by keeping the feet warm and dry, and changing sock
Sock
A sock is an item of clothing worn on the feet. The foot is among the heaviest producers of sweat in the body, as it is able to produce over of perspiration per day. Socks help to absorb this sweat and draw it to areas where air can evaporate the perspiration. In cold environments, socks decrease...

s frequently when the feet cannot be kept dry. Soldiers often wrote home about their daily lives living in the trenches, but also asked and pleaded for more socks, to help prevent things like trench foot.
During World War I, trench soldiers were provided with whale grease
Whale oil
Whale oil is the oil obtained from the blubber of various species of whales, particularly the three species of right whale and the bowhead whale prior to the modern era, as well as several other species of baleen whale...

 and told to apply it to their feet, to reduce the prevalence of this condition; the idea was to make the feet waterproof. It was found, however, that this made the condition worse as it made the feet perspire and absorb even more water. It was also discovered that a key preventive measure was regular foot inspections by officers.

History

Trench foot was first noted in Napoleon
Napoleon I of France
Napoleon Bonaparte was a French military and political leader during the latter stages of the French Revolution.As Napoleon I, he was Emperor of the French from 1804 to 1815...

's army in 1812. It was during the retreat from Russia
French invasion of Russia
The French invasion of Russia of 1812 was a turning point in the Napoleonic Wars. It reduced the French and allied invasion forces to a tiny fraction of their initial strength and triggered a major shift in European politics as it dramatically weakened French hegemony in Europe...

 that it became prevalent, and was first described by Larrey
Dominique Jean Larrey
Dominique Jean Larrey was a French surgeon in Napoleon's army and an important innovator in battlefield medicine.-Biography:...

.

It was a particular problem for soldiers in trench warfare
Trench warfare
Trench warfare is a form of occupied fighting lines, consisting largely of trenches, in which troops are largely immune to the enemy's small arms fire and are substantially sheltered from artillery...

 (hence the name) during the winters of World War I
World War I
World War I , which was predominantly called the World War or the Great War from its occurrence until 1939, and the First World War or World War I thereafter, was a major war centred in Europe that began on 28 July 1914 and lasted until 11 November 1918...

 and World War II
World War II
World War II, or the Second World War , was a global conflict lasting from 1939 to 1945, involving most of the world's nations—including all of the great powers—eventually forming two opposing military alliances: the Allies and the Axis...

, and in the Vietnam War
Vietnam War
The Vietnam War was a Cold War-era military conflict that occurred in Vietnam, Laos, and Cambodia from 1 November 1955 to the fall of Saigon on 30 April 1975. This war followed the First Indochina War and was fought between North Vietnam, supported by its communist allies, and the government of...

.

Trench foot made a reappearance in the British Army during the Falklands War
Falklands War
The Falklands War , also called the Falklands Conflict or Falklands Crisis, was fought in 1982 between Argentina and the United Kingdom over the disputed Falkland Islands and South Georgia and the South Sandwich Islands...

, in 1982. The causes were the cold, wet conditions and insufficiently waterproof DMS boots.

Some people were even said to have developed trench foot at the 2007 Glastonbury Festival
Glastonbury Festival
The Glastonbury Festival of Contemporary Performing Arts, commonly abbreviated to Glastonbury or even Glasto, is a performing arts festival that takes place near Pilton, Somerset, England, best known for its contemporary music, but also for dance, comedy, theatre, circus, cabaret and other arts.The...

, as a result of the sustained cold and wet conditions at the event.

See also

  • Immersion foot syndromes
    Immersion foot syndromes
    Immersion foot syndromes include:* Trench foot* Warm water immersion foot* Tropical immersion foot...

  • Chilblain
    Chilblain
    Chilblains are a medical condition that is often confused with frostbite and trench foot. Chilblains are acral ulcers that occur when a predisposed individual is exposed to cold and humidity. The cold exposure damages capillary beds in the skin, which in turn can cause redness, itching, blisters,...

  • Trench fever
    Trench fever
    Trench fever is a moderately serious disease transmitted by body lice. It infected armies in Flanders, France, Poland, Galicia, Italy, Salonika, Macedonia, Mesopotamia, and Egypt in World War I Trench fever (also known as "Five day fever", "Quintan fever" (febris Quintana in Latin), "Urban trench...

  • Trench mouth
    Trench mouth
    Acute necrotizing ulcerative gingivitis or necrotizing ulcerative gingivitis is a sub-classification of necrotizing periodontal disease, an infection of the gum tissue. This presents as an acute infection of the gingiva without involvement of the other tissues of the periodontium...

  • List of cutaneous conditions

External links

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