First-Aid Treatment for Friction Blisters: "Walking Into the Right Direction?".

OBJECTIVE

Blisters are common foot injuries during and after prolonged walking. However, the best treatment remains unclear. The aim of the study was to compare the effect of 2 different friction blister treatment regimens, wide area fixation dressing versus adhesive tape.

DESIGN

A prospective observational cohort study.

SETTING

The 2015 Nijmegen Four Days Marches in the Netherlands.

PARTICIPANTS

A total of 2907 participants (45 ± 16 years, 52% men) were included and received 4131 blister treatments.

INTERVENTIONS

Blisters were treated with either a wide area fixation dressing or adhesive tape.

MAIN OUTCOME MEASURES

Time of treatment application was our primary outcome. In addition, effectiveness and satisfaction were evaluated in a subgroup (n = 254). During a 1-month follow-up period, blister healing, infection and the need for additional medical treatment were assessed in the subgroup.

RESULTS

Time of treatment application was lower (41.5 minutes; SD = 21.6 minutes) in the wide area fixation dressing group compared with the adhesive tape group (43.4 minutes; SD = 25.5 minutes; P = 0.02). Furthermore, the wide area fixation dressing group demonstrated a significantly higher drop-out rate (11.7% vs 4.0%, P = 0.048), delayed blister healing (51.9% vs 35.3%, P = 0.02), and a trend toward lower satisfaction (P = 0.054) when compared with the adhesive tape group.

CONCLUSIONS

Wide area fixation dressing decreased time of treatment application by 2 minutes (4.5%) when compared with adhesive tape. However, because of lower effectiveness and a trend toward lower satisfaction, we do not recommend the use of wide area fixation dressing over adhesive tape in routine first-aid treatment for friction blisters.