Tuesday, November 15, 2011

The Importance of Foot Care in Deployed Service Members

Though modern warfare is much different than the conflicts in the 18th or 19th centuries, there are still many similarities in the way our men and women live while in country. Poor hygiene and lack of supplies to maintain that hygiene can be and are a real problem. At the Iowa Troop Pantry we try to supply our service members with all of the tools that they need: toothbrushes, toothpaste, deodorant, body wash, shampoo, baby wipes (for a quick clean), and Gold Bond powder.

The items that we have been notified that are most important, apart from food, are socks and foot powder. Men and women who are currently deployed run through socks like a soccer player during the World Cup. They are not supplied with a sufficient amount of socks to make sure they have a clean, usable pair for each day that they are deployed. They are not provided with foot powder, though its use can reduce the incidence of foot infections and syndromes. It is our job at Iowa Troop Pantry to provide those items to keep our deployed men and women healthy while they are away from home.

Below is an article from the Textbook of Military Medicine: Dermatology Medicine that details the origins of foot care in the military and two foot syndromes that are prevalent in deployed service members today.

Immersion Foot Syndromes

JOHN ADNOT, M.D. AND CHARLES W. LEWIS, M.D.

Since the founding of this country, American soldiers have been fighting wars wearing a wide variety of shoes and boots to protect their feet from the environment. Soldiers of the Continental Army, 1775 to 1781, wore simple low-cut leather shoes with the rough side out and cloth leggings laced over the lower leg.1 Joseph Lovell, a surgeon general in the 1800s, noted the importance of enabling soldiers to keep their feet warm and dry with wool socks and laced shoes reaching at least to the ankle. He also observed that letting the feet remain wet and cold for any length of time led to constitutional illnesses.2

In 1861, Union and Confederate soldiers wore any type of personally owned boot or shoe, but most used a simple, laced, ankle-high brogan. During the Civil War, Union troops were issued the first mass-produced shoes that distinguished between the left and right foot. Up to this time, most shoes were made to be worn on either foot. Many Confederate troops were barefoot or used canvas and wood to fashion crude walking shoes. Officers and mounted troops typically wore leather boots.2

Ankle-high, heavy leather shoes continued to be manufactured and were issued to soldiers during World War I. Wool wraps called puttees were wound around the lower leg from the knee to the ankle to protect the leg. It was not until the spring of 1918, however, that the Pershing boot, a heavier shoe with more waterproof construction, was developed. 3 It was effectively designed for the demands of trench warfare. After the war, modifications on footwear reflected garrison life and the need for economy.3

Ankle-high shoes and canvas leggings were initially worn in World War II. Because of material shortages and lack of preparedness for the footwear needs of wartime, despite the experience available from World War I, it was not until the end of 1943 that the first combat boot appeared.3 It was a brown laced boot with a leather flap on the upper. Because leather is a permeable material, all leather boots leak to some extent. It was not until 1944 that the M-1944 Shoepac, with a moccasin-type rubber boot, was approved for distribution

The type of footwear worn by the soldier in combat, along with environmental conditions and preventive hygiene measures, has played a crucial role in producing a variety of cutaneous disorders of the feet. These “disease, nonbattle injuries” range from minor inconveniences to very significant conditions that may result in hospitalization.

Trench Foot

“Trench foot” refers to injury resulting from prolonged exposure to wet conditions, without immersion,in cold weather. The term probably originated in World War I, when many men were confined to trenches in cold, damp weather for prolonged periods. The condition was recognized as a cause of considerable loss of manpower as far back as the Greek Campaigns6 and the Napoleonic and Crimean Wars.7,8 Yet these lessons seem to have been lost on modern armies. In Europe during World War II, American forces sustained 11,000 cases of trench foot in November 1944 with more than 6,000 in the Third U.S. Army alone.9

Clinical trench foot will develop if exposure lasts 48 hours or longer.8 Other contributing factors include nutritional deficiency; trauma (rubbing or walking on affected feet); wind; improper clothing type and integrity; circulatory stagnation and tissue anoxia from dependency, inactivity, hemorrhage, or shock; and improper technique used to rewarm an injured limb.7

Immersion Foot

Immersion foot can be considered the sailor’s counterpart of the soldier’s trench foot. The term “immersion foot” was first used during World War II to describe a syndrome of clinical conditions occurring in extremities exposed to prolonged, continued immersion in water of temperature ranging from above freezing to 15°C.

Source: http://www.fas.org/irp/doddir/milmed/milderm.pdf

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