Cold-weather warfare
Trench foot is a medical condition caused by prolonged exposure of the feet to damp, unsanitary, and cold conditions at temperatures as warm as for as few as 13 hours. Exposure to these environmental conditions causes deterioration and destruction of the capillaries and leads to morbidity of the surrounding flesh. Affected feet may become numb, affected by erythema (turning red) or cyanosis (turning blue) as a result of poor blood supply, and may begin emanating a decaying odour if the early stages of necrosis (tissue death) set in. As the condition worsens, feet may also begin to swell. Advanced trench foot often involves blisters and open sores, which lead to fungal infections. If left untreated, trench foot usually results in gangrene, which may require amputation. If trench foot is treated properly, complete recovery is normal, though it is marked by severe short-term pain when feeling returns. Trench foot affected tens of thousands of soldiers engaged in trench warfare in World War I. Keeping feet warm and dry, or at least changing into warm and dry replacement footgear, is the best way to avoid trench foot.
Tenosynovitis
The mainstay of treatment for infectious tenosynovitis includes symptom relief, antibiotic therapy, and surgery. Early recognition of the disease with early initiation of antibiotics are important for better range of movement of the affected finger. Minimally invasive procedures into the flexor tendon sheath such as catheter irrigation give better outcomes (74% chance of good outcome) when compared to open surgery (26% chance of good outcome). However, wound irrigation with antibiotics has no clear benefits. Most infectious tenosynovitis cases should be managed with tendon sheath irrigation and drainage, with or without debridement of surrounding necrotic tissue, along with treatment with broad-spectrum antibiotics. In severe cases, amputation may even be necessary to prevent the further spread of infection. Following surgical intervention, antibiotic therapy is continued and adjusted based on the results of the fluid culture.