Suito Motomu, Yanagida Takuya, Ohtsubo Miho, Tsunekawa Kazuhiro, Kikuchi Niro
Department of Plastic and Reconstructive Surgery, Aizawa Hospital, Matsumoto, Nagano, Japan.
Department of Plastic and Reconstructive Surgery, Shinshu University School of Medicine, Nagano, Japan.
Int J Low Extrem Wounds. 2024 Oct 4:15347346241273138. doi: 10.1177/15347346241273138.
Cold associated foot injuries, such as frostbite and trench foot (immersion foot) are relatively common in cold environments. The former is classified as a freezing cold injury, and the latter as a nonfreezing cold injury. Trench foot is sometimes misdiagnosed as frostbite, and rapid rewarming exacerbates the condition. This paper aims to help differentiate between frostbitten foot and trench foot. This study included patients with frostbitten foot or trench foot treated at our hospital between December 2005 and May 2023. The differences in sex, age, month of injury, conditions at the time of injury, injury distribution, foot lesion laterality, other complications upon arrival (finger frostbite, immersion hand, or hypothermia), and presence and distribution of sensory disturbance at discharge were noted among the groups. A total of 16 patients (14 men) with frostbitten foot and 3 patients (3 men) with trench foot were identified. Finger frostbite observed in nine and zero patients with frostbitten foot and trench foot, respectively; and severe hypothermia on arrival observed in five and zero patients with frostbitten foot and trench foot, respectively. Physical findings at the initial examination showed that the frostbitten feet were dry, and the lesions were distal and clearly demarcated, whereas feet with trench foot were wet, and the lesions covered the entire sole and were not clearly demarcated. Accurate differentiation between frostbitten foot and trench foot and appropriate initial treatment are important. The presence of finger frostbite, immersion hand or severe hypothermia may help to differentiate between frostbitten foot and trench foot.
寒冷相关的足部损伤，如冻伤和战壕足（ immersion foot，浸足）在寒冷环境中相对常见。前者被归类为冻冷损伤，后者为非冻冷损伤。战壕足有时会被误诊为冻伤，快速复温会使病情加重。本文旨在帮助区分冻伤足和战壕足。本研究纳入了2005年12月至2023年5月在我院接受治疗的冻伤足或战壕足患者。记录了两组患者在性别、年龄、受伤月份、受伤时的情况、损伤分布、足部病变的侧别、入院时的其他并发症（手指冻伤、浸手或体温过低）以及出院时感觉障碍的存在和分布情况。共确定了16例冻伤足患者（14例男性）和3例战壕足患者（3例男性）。分别有9例和0例冻伤足和战壕足患者观察到手指冻伤；分别有5例和0例冻伤足和战壕足患者入院时出现严重体温过低。初次检查时的体格检查结果显示，冻伤足干燥，病变位于远端且界限清晰，而战壕足潮湿，病变覆盖整个足底且界限不清晰。准确区分冻伤足和战壕足并进行适当的初始治疗很重要。手指冻伤、浸手或严重体温过低的存在可能有助于区分冻伤足和战壕足。
