With the Sydney Half Marathon this weekend and your City2Surf training well underway, we thought it would be appropriate to discuss BLISTERS.
The treatment of blisters has divided the health care system. With inconsistent information, we turn to expert opinion.
Depending on the blister, treatments range from (1) No treatment and leaving blister intact, (2) to lancing the blister allowing the fluid to drain whilst maintaining the overlying skin OR (3) completely de-roofing the blister.
Firstly, a blister is recognised as “A small bodily fluid within the epidermal layer of the skin. This fluid is generally a clear fluid however it has the potential to be purulent, haemoserous or cloudy fluid”. Allergic reactions, burns, viral skin infection and fungal skin infection can cause blisters.
However, the blisters, we are going to discuss are caused by skin shear. (Friction)
Skin shear is whereby a particular area of skin is mechanically forced to move parallel to the surface of the body. Small tears in the epidermal layer occur which is filled with the fluid.
Let’s outline the most ideal way to treat the three different forms of blisters.
(1) Intact Blister
An intact blister is the preferred form of Blister, as the skin is a natural barrier preventing infection. The fluid sack also promotes a moist wound bed, which is an ideal healing environment.
The aim of treating the blister is to prevent skin shear, which is simply skin stretching. With the goal of maintaining the skin integrity and keep it intact, we need to address the initial cause.
1. Even though the skin is still intact and preventing infection, we still need to dress the blister with a form of island dressing (band-aid, Smith & Nephew- adherent island dressing or something similar)
2. Depending on where the blister is you should aim to offload, though the use of felt padding doughnut or change of footwear
3. Finally, we need to moderate the shearing level. This can be obtained by using a product called Engo Blister patch, which come in a variety of different sizes, which attach to your shoe. If you are looking for a quick temporary fix, Vaseline works well as a lubricant, to prevent shearing.
(2) Popped Blister- however still has the skin overlying.
The process doesn’t change much from the previous blister. The aim is to preserve the skin overlying the blister and prevent infection.
Complete the three steps recommended above and incorporate the additional steps below:
1.Apply an antiseptic, which destroy or inhibit the growth of microorganisms in or on living tissue.
2.Once daily observer for signs of infection
- Expanding redness around the wound.
- Pus or cloudy wound drainage.
- Increased temperature around the wound.
- Swelling around the wound.
(3) De-roofed Blister
De-roofing a blister is the worst possible outcome. You should try and prevent this at all cost as a de-roofed blister become painfully raw and an open portal for infection.
When treating this type of blister the aim is to provide a moist wound-healing environment. Complete all the above steps above with a particular emphasis on regularly applying antiseptic and monitoring signs of infection.
City Feet Clinic recommends hydrocolloid dressing, as they formulate a gel on the wound bed, endorsing optical wound moisture for healing. Compeed offers a good range of excellent dressings; if you cant get your hands on Compeed, Band-Aid offer a gel strip advanced healing regular which will do the job.