Blister Treatment

[Just_Me]

Compeed gets a mention frequently. An good alternative (if Compeed is unavailable, too pricey etc) is Duoderm extra thin or Duoderm - both work on the same hydrocolloid treatment base as Compeed and is widely used in wound care.
It is wonderful also for split heels or fingertips - you know those really, really painful splits!
I buy it off eBay for a much lower price, they are often factory seconds due to misalignment of the patch which does not affect the efficacy. One patch measures 10x10cm and you get heaps out of it, a packet contains 10 patch and lasts years.
I have used it in nursing extensively and keep a packet at home (mostly for those pesky split fingertips).

 

[willydp]

This is a good argument not to use Compeed but Duoderm instead:
"The dressing can be removed without damaging newly formed tissue."
Compeed has to stay untill it drops.
I had a bad experience with Compeed that came partial loose due to friction (+30km walk in the rain with bad military boots and a bunion), a little bit messy, and sticking to the sock.
Took longer to heal the wound.
So this can be a good alternative.
Can you take a shower with it?
Thanks for the information

 

[Br. Dick Tandy ofm]

I'm curious about this, Adventure Medical Kits GlacierGel Blister and Burn Dressing. It's at REI. Am I would like Y'alls opinion on this product?
Thanks and Bueno Camino.

 

[howardd5]

This is a good argument not to use Compeed but Duoderm instead:
"The dressing can be removed without damaging newly formed tissue."
Compeed has to stay untill it drops.
I had a bad experience with Compeed that came partial loose due to friction (+30km walk in the rain with bad military boots and a bunion), a little bit messy, and sticking to the sock.
Took longer to heal the wound.
So this can be a good alternative.
Can you take a shower with it?
Thanks for the information

I agree ,i never use compeed . Vasolene and a taped dressing.drain in evening and repeat

 

[JR9162]

I used Equate brand moleskin purchased at Walmart on the VdlP last spring. Cut it with scissors and apply to cleaned blistered area. Left it on until it would no longer stick. Then replaced the application with a freshly cut piece. I had blisters on the side of my heels where the sole of my foot began, also between my smaller toes on both feet. Eventually calluses developed when I peeled off when I returned home from my Camino. Worked for me. I tried vaseline between my toes without success.

Whenever the blister popped I applied Bacitracin ointment to the broken skin, topped with the moleskin dressing.

For splits on my fingers, I rub chapstick on them and rub into the split. Effective for taking the sting away.

 

[Deleted member 67185]

Here is a repost of mine about treating blisters. It may be of help to some

-----------------------
As with most things in life, there are two variables for treating blisters.

1. Do not drain the blister.
2. Drain the blister and keep it drained.

The concern about draining a blister is that it can provide a route of infection because the skin is opened, allowing some exposure to a wound. While this is true, it is also true that with proper care the risk is low.

To keep a blister intact, an highly experienced Forum member, dougfitz, provided this guidance:

• That first step is to leave an intact blister intact and not to puncture it as a first response.
• The priority should be to protect the blister roof by using an island dressing or cutting a doughnut shape to fit over the blister that will protect it from both direct pressure and further shear stress.
• You can make the doughnut from a couple of layers of ordinary moleskin, or a single layer of padded moleskin, and keep that in place with Fixomull or a similar conforming tape.

This post is primarily focused on treating a blister by draining it. It is meant to provide guidance into the best practices in order to walk more comfortably with a blister. However, it assumes some things:

• You are not going to take time off to let your blister start to heal.
• You are needing or wanting to continue walking with your blister.
• The blister is prominent and large enough to cause discomfort while walking.
• There is some likelihood that the blister’s ‘roof’ will become ripped or torn while you are walking.

Blister treatment falls under hygiene level two. So, clean hands (soap and water, or hand sanitizer, or rubbing alcohol, etc). All that needs to be done is to cleanse hands so that the level of potential pathogens is reduced to below the level which could cause infection to this type of wound.

Also, any product used to dress the blister should be clean as well. It doesn't have to be sterile, but should at least be in its protective packaging.

1. If the blister still has it's 'roof', it is recommended to leave the 'roof' intact, but to drain the fluid. Needles are not the ideal tool, as the initial puncture can reseal later, allowing fluid to build up again. A disinfected tool (alcohol or flame from a lighter/match) which can create a slit at the base of the blister near the skin of the foot is best --- a pair of tiny scissors to snip a slit; a disposable scalpel blade or a hobby knife blade as part of a first aid kit.
2. If the blister has 'de-roofed', then trim off any skin tag which might flap back into the raw open wound.

Preparing the wound for dressing

1. Cleaning the wound by flushing away any debris away with clean water or a mild dilution of hydrogen peroxide. Pouring or squirting the wound is fine, but any dirt particles sticking to the wound MUST be cleared away.

2. A topical antibiotic ointment, not creme, is gently applied after the blister wound is dry. The ointment serves two purposes: it reduces any risk of infection and it prevents any dressing material from inadvertently adhering to the wound.

Blister Dressing

A primary issue is getting whatever method of dressing used -- be it taping, Moleskin, hydrogel pads, bandaids, etc --- to stick and remain in place, which can sometimes be a huge challenge.

Here are a few strategies to help.

1. Use hand sanitizer or alcohol to clean the skin area, not the wound, to which the tape or dressing will be stuck to. Get as much dirt and body oils removed as is possible.

2. To the cleansed skin, apply a thin smear of Tincture of Benzoin then allow to dry. Do not put any directly on the wound. This will multiply the holding power of the adhesive that is used. If you aren’t familiar with it, think of it as rubber cement for the skin.

I carry a few crushable ampules of the stuff. You can get them on Amazon or at a pharmacy

3. When the adhesive is finally applied, rub the area of the tape or moleskin or Compeed or etc... The idea is to create heat from the friction to allow the adhesive to warm and adhere better.

For dressing a blister, this NOLS video does a good job of describing the methods which work best. For a blister with a roof, I like to place a hydrogel dressing, like Spenco, to the top of the blister and them use Leukotape P or Omnifix or etc... to affix the dressing in place. The hydrogel provides basic cushioning and additional protection, helping the tape to reduce additional damage to the wound.

For a de-roofed blister, the addition of the ointment to the open wound is applied prior to the hydrogel being put into place. The hydrogels are package and designed to be sterile. Bandaging is done as previously described.

IF the blistered area, whether roofed or de-roofed, is so tender it is uncomfortable to walk on as treated above, then remove the dressing and then redress the blister the same way as before, but with the addition of using the 'doughnut' padding as the NOLS video demonstrates.

Unless additional attention is needed, it is best to leave the dressing in place until the end of the day. Then, remove the dressing, re-cleanse the wound, shower, cleanse, apply ointment, and redress for evening activities. At bedtime, remove the dressing, re-cleanse and apply antibiotic ointment and wear a clean sock.

The next morning, carefully evaluate for any sign of infection, and apply ointment and redress the area for a new day of walking. Check again for signs of infection periodically during the day without removing the covering. If the wound seems worse, then think about taking at least a day off to let the wound do a bit of healing. Even a half-day off your feet can be of help.

To help evaluate a blister for infection:

With freshly and thoroughly washed hands (alcohol based hand sanitizer will work, too), feel the area around the blister for signs of:

• warmth
• foul smell
• pus
• pain
• swelling
• holes or peeling skin
• the area bleeds when you touch it, or doesn’t seem to be healing at all.

If any of these symptoms occur, you need to be seen by a medical provider for proper evaluation and treatment.

Be aware that even if the blister has been left intact, it is still possible for infection to occur, so evaluate ALL blisters, intact or not.


-------------------------------------------

 

[dougfitz]

Here is a repost of mine about treating blisters.

While the advice @davebugg provides is good, most reputable sources on blister care, including the NOLS video he has a link to, recommend one or more preliminary steps in a blister care regime. That first step is to leave an intact blister intact and not to puncture it as a first response. The priority should be to protect the blister roof by using an island dressing or cutting a doughnut shape to fit over the blister that will protect it from both direct pressure and further shear stress.

You can make the doughnut from a couple of layers of ordinary moleskin, or a single layer of padded moleskin, and keep that in place with Fixomul or a similar conforming tape.

Here are some links on this subject. The first two are from the US Army. The other two are from equally reputable sources. The article from Rebecca Rushton has a particularly good explanation about when to, and when not to, use hyrocolloid blister plasters like Compeed.

US Army #1
US Army #2
Mayo Clinic
Rebecca Rushton

 

[Deleted member 67185]

While the advice @davebugg provides is good, most reputable sources on blister care, including the NOLS video he has a link to, recommend one or more preliminary steps in a blister care regime. That first step is to leave an intact blister intact and not to puncture it as a first response. The priority should be to protect the blister roof by using an island dressing or cutting a doughnut shape to fit over the blister that will protect it from both direct pressure and further shear stress.

You can make the doughnut from a couple of layers of ordinary moleskin, or a single layer of padded moleskin, and keep that in place with Fixomul or a similar conforming tape.

Here are some links on this subject. The first two are from the US Army. The other two are from equally reputable sources. The article from Rebecca Rushton has a particularly good explanation about when to, and when not to, use hyrocolloid blister plasters like Compeed.

US Army #1
US Army #2
Mayo Clinic
Rebecca Rushton

Thank you for posting this, Doug; I appreciate and value your expertise and insights on these issues.

You are absolutely right about the best course of action being to not drain a blister. Whereas I had generically advocated for draining a blister, the sources agreed that such should be reserved for situations where a blister is full and tight, is painful to walk on, or would be at risk for the roof of the blister tearing away.

Would you find my post to be a more complete and accurate overview by my modifying my post to incorporate your suggested protocol for blisters that are smaller, not painful, and not at risk of tearing? I definitely want to have as useful a resource as possible.

Thanks, Doug

 

[Rick of Rick and Peg]

Dave, you probably should say that the best practice is to leave it undrained but that would be in the case where you are not walking further. That is definitely impractical for pilgrims. So if walking with an undrained blister is uncomfortable or would do damage to it then do the following. ...

 

[willydp]

You can walk with pain, but I experienced more then once that the blister broke and that was a huge relief...made walking much easier.
Medical treatment was for the evening...
Cleaning, disinfecting and Compeed was the only solution at that time.
Not to recommend.
So be prepared and take all what has been described before with you when you start and feel the first signs.
Thanks for all the info

 

[dougfitz]

Whereas I had generically advocated for draining a blister, the sources agreed that such should be reserved for situations where a blister is full and tight, is painful to walk on, or would be at risk for the roof of the blister tearing away.

I think that this is a reasonable statement to make. If walkers haven't been paying attention to hot spots, but do start treatment before the blister gets to large, then it is reasonable to keep the blister intact. Yes, it might still burst, and then further treatment stages will be necessary. I know I recently did this myself when I should have paid more attention to a hot spot, but didn't. I was still able to protect the blister from bursting with a doughnut made from a couple of layers of moleskin.

Once I had done that, I was able to continue walking, albeit a little less comfortably than if I had treated the hot spot, but certainly far more comfortably that before. The doughnut was on for a few days, and it was a few weeks later that the skin peeled off - more than enough time for the underlying skin layer to harden up and not need any treatment at all.

you probably should say that the best practice is to leave it undrained but that would be in the case where you are not walking further.

I don't agree with this. Best practice will always be to preserve as much of an intact skin layer as possible. So if the skin is intact, make every effort to keep it so. Sure, if you have ignored the signs and continued walking to the point where the blister has grown so large that this first level of treatment won't work, you are already your own worst enemy in this regard. You have already exposed yourself to all the extra infection risks that come from a broken skin layer. But don't if you don't have to.

There is also the issue of what you might be carrying to treat blisters. If all you have is a few sticking plasters and hydrocolloid dressings, you can deal with a hot spot or a de-roofed blister, but you won't be able to make a good doughnut dressing for an intact blister or one that has gone a bit further where it is appropriate to drain properly. Your treatment options are missing the middle range where the roof has been torn, or pierced deliberately, to drain the blister.

 

[trecile]

For me, the best thing for prevention is knowing my feet, and where they tend to get hot spots. Then I put Omnifix tape on that area every day before I start walking. The tape is like a security blanket for my feet.

 

[linkster]

I like tapes like Omnifix or Hypafix, but I think Leuko P Tape adheres much better.

+1 Spenco 2nd skin.

Gel toe sleeves work well for blisters between toes.

A single use Povidone Iodine pad steeped in a ziplock with some water makes a pretty good irrigation solution. Cut a small hole in the corner of the bag to dispense.

 

[Just_Me]

This is a good argument not to use Compeed but Duoderm instead:
"The dressing can be removed without damaging newly formed tissue."
Compeed has to stay untill it drops.
I had a bad experience with Compeed that came partial loose due to friction (+30km walk in the rain with bad military boots and a bunion), a little bit messy, and sticking to the sock.
Took longer to heal the wound.
So this can be a good alternative.
Can you take a shower with it?
Thanks for the information

yes, no problems with showering (or doing dishes if used on hands)

 

[rorygilmore]

for australians- you can get the large duoderm bandages at chemist warehouse and cut them into personalised bandage sizes, they cost about 7 bucks but its a big bandage and you would get lots of use out of one! i use em for acne, lol

for germans-
Cosmoplast Schürfwundenpflaster from DM apparently. i havent bought one yet but will soon.