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Discussion Forum - The Bothy - Blisters - To prick, or not to prick


Author: Janet Pitt-Lewis
Posted: Thu 28th Mar 2019, 17:47
Joined: 1993
Local Group: Marches
The Spine Race approach


https://dartmoordogrunner.blogspot.com/2018/12/avoidable-dnf-situations.html?fbclid=IwAR1kCzZdRIxcksYkU6HJleJGqjd2-s68qYpCWJiMuvh5daBtIGZlrAJ6JTw
Author: Simon Pipe
Posted: Thu 28th Mar 2019, 2:53
Joined: 2006
Local Group: Heart of England
Handy advice on blister treatment, including video, on the Dragon's Back Race website: http://www.berghausdragonsbackrace.com/latest-news/2018/12/18/Guidance_on_Foot_Care_for_Participants_at_the_2019_Berghaus_Dragons_Back_Race/
Author: David Green
Posted: Tue 5th Jun 2018, 20:26
Joined: 2003
Local Group: Dorset
@John Pennifold. It's just a blister for Christ's sake!
Author: Raymond Wilkes
Posted: Sat 23rd Dec 2017, 19:58
Joined: 2013
Local Group: West Yorkshire
It works by osmosis. Water will always flow from a weak solution to a strong one. It can do this through the skin which is semi -permeable.
I knew this should work for blisters but I did not know a practical way of doing it. Thanks!

osmosis is traditionally demonstrated in school biology lessons with a scooped out potato.
Author: Michael White
Posted: Fri 22nd Dec 2017, 20:13
Joined: 2017
Local Group: Northumbria
Im a nurse, work in elderly care. We had an elderly lady who developed a huge blister on the instep, just above her toes, and on the sole of her foot, no apparent cause! Whe I say huge I mean huge, approximately 5cm in hight! Anyway this went on for several days and a GP came in to review, a German doctor who had experience working with burns. She asked for some cream, E45, and salt. She mixed the salt in with tthe cream and applied it to the blisters. Within minutes fluid began seeping from the blister without breaking the skin. I was amazed! Food for thought.
Author: Stuart Dodson
Posted: Fri 28th Jul 2017, 10:53
Joined: 1993
Local Group: Lincolnshire
I use Physio anti friction cream with good success; but have used Avon foot balm as well.
I am in for piercing at both ends of the blister to drain; make it good so the holes do not heal together quickly. I have also seen advocated sewing through and leaving a thread to stop closure and refilling with liquid. Leave the skin on as long as possible -it is the best protection having been designed for it. If it is raw I would protect it with micropore tape.
Though I cannot find the source again I know the USA military carried out studies and found that treated properly the blister skin reattaches;this has been my experiences in the past.
Author: John Dally
Posted: Wed 26th Jul 2017, 8:30
Joined: 1990
Local Group: East Yorkshire
Hi, Thanks to all those who have taken time to respond to this item. I used vaseline myself at one time, but now use zinc and castor oil. If it's good enough for babies' bottoms, it's good enough for me. My blisters more or less ended when I went into trainers, but I am lucky and have no problems with wet feet.
Re application of Compeed, I was having difficulty warming the patch up before application as I was in a cold wet environment at the time will not go into detail as to which part of my anatomy I was using to get up to temperature. However, I was told later on that 100 that, if possible, warm the Compeed against a mug of warm liquid. I did so and got a perfect seal
Author: Elton Ellis
Posted: Sat 22nd Jul 2017, 19:52
Joined: 2006
Local Group: Surrey
If a blister develops, i stop (ie I don't wait until the next CP) and apply a hydrocolloid gel blister patch (eg Compeed). Invariably a bit of a blister has formed already, but the gel cushioning absorbs the frictional movement and usually prevents it worsening. I never drain.

I usually apply a blister patch over an area which is prone to blistering before i start on a long (20 miles plus) walk.
Author: Raymond Wilkes
Posted: Tue 18th Jul 2017, 16:21
Joined: 2013
Local Group: West Yorkshire
As John says prevention is the best option and quick reaction to any soreness but I sometimes ignore soreness and regret it later
Friction is the cause so I use liner socks and sometimes vaseline if I know rubbing is occuring.
Do not wear new footwear on a challenge walk unless it is an exact replica previous boots which are know to be problem free on first wearing
But you can jsut be damned unlucky, a 2 mile walk along my local canl path once gave me a really bad blister hust before a weekends walking, which I called off part way through
I very rarely get blisters and a high proportion have been with trainers instead of boots. These appear under my foot with seemingly no warning.
One was a very long time ago on my 6 hour 24 minute 3 peaks of Yorkshire and that was the one which needed antibiotics
Author: John Pennifold
Posted: Tue 18th Jul 2017, 11:52
Joined: 1996
Local Group: London
Thinking about this subject it occurred to me that this should really be a subject of a Risk Assessment. This is because of possible action or in-action causing injury to members.
I looked at the NYM 100 Risk Assessment but it doesn't go into any detail of First Aid. Maybe a section on LDWA-specific injuries is needed?
Possible risks would appear to be (amongst others)
1) Infection of a blister
2) Inappropriate treatment of a blister
3) Ignoring blister leading to later complications

The most difficult area appears to be around 'What IS the appropriate treatment of a blister?'. I remember a few years ago on a First Aid course being told to drain a blister but as they pointed out, First Aid advice is continually updated, so one has to keep abreast of the situation. Googling several First Aid training websites would indicate that currently it is NOT recommended to drain a blister, but several go on to say it SHOULD be drained if it looks as if it is going to burst anyway. I think most advice is based on the implicit assumption that the the activity causing the blister has already ceased, but of course with LDWA members this is not the case so perhaps special advice is needed for us. Bearing in mind that most walkers would continue with a blister unless it has become too painful or raw, then it would seem appropriate to drain it as soon as possible as it's only going to get bigger and burst later if the walker continues. Only if the walker retires would it seem appropriate to NOT drain it.
It would appear important to clean the sorrounding area, to use a sterilised needle to prick a blister and to apply iodine or similar. First Aid advice suggests pricking the blister near the edge and allowing it to drain, but in my experience if it's under thick skin then it's best to go for the middle but inserting the needle at a low angle to avoid the point making contact with the otherside of the fluid-filled cavity. Often several holes might be needed and pressure is nearly always needed to expel the fliud. The relief can be almost immediate once drained. Once drained, a Compeed can be applied. It's no use applying a Compeed to an undrained blister if the walker intends carrying on.
It would seem that First Aiders need special training in the use of Compeed and in the stubborness of LDWA walkers. Both would seem to defy common sense. The most important thing about Compeed is that once applied, they should be allowed to fall off in their own time (several days at least) and not forcibly removed.

The most important thing though is to prevent blisters in the first place. This website offers the most useful information that I have found so far https://www.skinsight.com/skin-conditions/first-aid/first-aid-blisters. Interestingly, they recommend acrylic socks as cotton or wool socks can become misshapen during use; this matches up with my own experience, as since using acrylic socks I rarely get blisters. Discussion about 'wicking' socks is a waste of time, as once a sock is wet, it's wet and nothing can be done.
I think the advice about using talc is probably useful for 'dry' activities, but inevitably feet get wet on most LDWA walks which reduces talc to a sodden cream.
Compeed should be applied at the first sign of pressure and not wait until a blister forms (which can form as soon as a few minutes after noticing the pressure). Anybody who allows a blister to get so bad so that it 'de-roofs' (loses the outer layer) before starting treatment should almost certainly withdraw as Compeed on raw skin isn't going to help then to continue.

I did visit the Johnson & Johnson Compeed website https://www.compeed.co.uk/footcare-centre/compeed-blister/how-to-apply for advice but it has nowhere the level of detail that I was hoping for.
Author: John Dally
Posted: Mon 17th Jul 2017, 23:48
Joined: 1990
Local Group: East Yorkshire
Re the two previous comments; I and just about everyone else have suffered cuts and grazes on many occasions which I have left untreated and not suffered infection. It's just swings and roundabouts.
However, the reply from Grae Yeandle shocked me. On the rare occasion I have had to treat a blister, I have done so early in its development and before too much liquid has accumulated under the skin. The idea being to flatten and dry the area and provide some cushioning (protection) for which I have used Compeed with great effect over the past 25 years. However, if the blister has burst, or the skin stripped thus exposing raw flesh, the effectiveness of any dressing is reduced.
What shocked me is that it would appear that the first aider referred to by Mr Yeandle appears to have been trying to remove already applied Compeeds. This is near impossible due to the dressing's strong adhesive qualities and the normal practice is to wait for the dressing to drop off after 4 or 5 days. If, as I suspect, the Compeeds were beng forcibly removed, I would expect already damaged skin to be stripped off, leaving possibly largish areas of raw angry flesh. In such circumstances, I am not surprised that professional treatment was then required.
It's almost certain we all have our own favourite method; all I'm offering is what works for me on the rare occasions I have had to carry out such repairs.
Author: Raymond Wilkes
Posted: Mon 17th Jul 2017, 20:59
Joined: 2013
Local Group: West Yorkshire
I have had blisters burst on their own volition and when taking my boots off found blood and mud ingrained, but with no long term ill effects
The one time I burst one with a carfefully sterilized needle it went septic and I had to have antibiotics!

I never had problems with compeed other than that they do not always allow pain free walking
Author: Grae Yeandle
Posted: Mon 17th Jul 2017, 19:21
Joined: 2001
Local Group: South Wales
There was a discusion on the LDWA facebook page not long ago, that started with this comment
"Plea from a FIrst aider !!!!! PLEASE PLEASE don't put comped on already developed blisters - I have had to remove way to many this weekend with the result being 3 people advised to attend minor injuries clinic after the walk ! These disgusting things should be banned !!!!"
Author: John Dally
Posted: Sun 16th Jul 2017, 19:22
Joined: 1990
Local Group: East Yorkshire
I apologise if this is an old subject, but maybe views have changed. I was watching today's Wimbledon Men's Final when it appeared that a player's blisters where being treated with what appeared to be nothing more than cushion pads. I mentioned that I had always dealt with any blister by using a clean safety pin to puncture the blister, squeeze the liquid out, flatten the skin and apply a dressing such as Compeed.
My companion, who has medical knowledge, was horrified saying that my method risked infection. My reply was that if the blister was allowed to grow and burst, the risk of infection was even greater. My friend could not be swayed and therefore I put forward the matter for discussion.
I would add that one event in particular insists we include safety pins in our first aid kits and I have never found any use for them other than to burst the occasional blister

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