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Most effective way to use Compede?

Camino(s) past & future
Walked from O'Cebreiro to Santiago in 2016
Planning to walk from Burgos this June, 2018
#1
Hello,
I have read that Compede is to be used after a a blister has ruptured and when the top layer of skin has come off. I also understand that one can wear them for longer than a day. I used Compede in this way on my last walk and thought they were okay to wear in the shower. But what I found was that they became goopy around the edge, and I worried that moisture seeped in and would make the friction worse throughout the next day.

Should they be worn for more than a day? In the shower? I hope I don't need them this time, but assuming I will, what is the most effective way to apply and use them?
Thank you,
Lynne
 
Camino(s) past & future
Camino Frances ( March 2015 )
Camino Portugues ( September 2015 )
#2
Hi Lynne

They do become goopy if shower with them on. I treated myself to a new patch each day.
I also found that putting some tape over the top of them prevented them from sticking
to my socks.

Hope you don't need them!

Buen Camino
 
Camino(s) past & future
2015-2016 VdlPlata - Sanabres
2016.Primitivo
2017 Salvador
2018 Norte?
#5
I've always understood that it is best to leave them on a few days. In the shower you should keep it as dry as possible. Taping them extra is a good idea, perhaps they help also to keep the compeed dryer in the shower
 
Camino(s) past & future
Camino Frances, 2015
#6
Hello :D

Compeed is to be worn on unbroken blisters - never on ruptured ones! You put it on clean dry skin and wear it until it comes of on its own.

If you read the small instruction inside the packet it explains so.
The other way around. See the link above. If put on an intact blister when you remove the bandage it has a good chance of ripping the blister's roof off.
 
Camino(s) past & future
2008
2013
(2018)
#7
If you put them on ruptured blisters, the create a nice warm and moist environment for germs to grow. When you put it on the unbroken it creates a small cavern around the blister to create pressure relieve. You are not supposed to remove it until it comes of by itself, which it will when there is new skin on the blister.

That is the theory behind the compeed....
 
Camino(s) past & future
Walked from O'Cebreiro to Santiago in 2016
Planning to walk from Burgos this June, 2018
#10
Camino(s) past & future
Walked from O'Cebreiro to Santiago in 2016
Planning to walk from Burgos this June, 2018
#11
Hi Lynne

They do become goopy if shower with them on. I treated myself to a new patch each day.
I also found that putting some tape over the top of them prevented them from sticking
to my socks.

Hope you don't need them!

Buen Camino

Good idea about the tape. Will do it...but I hope I won't need it.
Thanks again,
Lynne
 

Glamgrrl

Active Member
Camino(s) past & future
Travel318
#13
Everything I’ve read and watched state exactly the opposite. Watch the video linked in comments on this thread. I’ve used compeed for burns and also for a deep cut. It acts like a new skin until yours has grown back. The goopy is essentially what your skin does when healing. That goopyness is what hardens to form a scab if you didn’t have a bandied on. With a hydrocollid bandaid, the intent is to protect the wound and help it heal with less of a scar. The goopyness is Ok.
 
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Anamiri

Active Member
Camino(s) past & future
Camino Frances
#15
If you put them on ruptured blisters, the create a nice warm and moist environment for germs to grow. When you put it on the unbroken it creates a small cavern around the blister to create pressure relieve. You are not supposed to remove it until it comes of by itself, which it will when there is new skin on the blister.

That is the theory behind the compeed....
The wording actually says to be used on deroofed blisters. Where the skin is already gone.
 
Camino(s) past & future
SJPDP-Finisterre X 2, El Norte incompleto
#16
If you put them on ruptured blisters, the create a nice warm and moist environment for germs to grow. When you put it on the unbroken it creates a small cavern around the blister to create pressure relieve. You are not supposed to remove it until it comes of by itself, which it will when there is new skin on the blister.

That is the theory behind the compeed....
That's not the theory behind Compeed. And it's designed to keep bacteria out of the wound.
 

davebugg

"When I Have Your Wounded" - Dustoff Motto
Camino(s) past & future
Camino Frances...
Sept. 2017: SJPdP to Burgos
Sept./Oct. 2018: SJPdP to Santiago de Compostela
#17
KT Tape has a fairly recent product out which I have heard some very positive things about. KT Performance+ Blister Treatment Patches. They are a similar idea to Compeed, but have a better adhesive, and the adhesive is said to create less allergic reactions in some individuals. I personally haven't used it for blisters, since I don't really get them, but I have used it on a nasty scrape to the forefoot (barefoot and sharp asphalt). It worked pretty much as advertised.

https://www.kttape.com/kt-performance-blister-treatment-patch/
 

Karl Oz

Active Member
Camino(s) past & future
Frances
Portuguese
Piamonte
Aragones
Elizabethpfad
#18
As you can see, some people swear by them, and some people swear at them. I have been in both camps. I have used them on both intact and raw blisters and didn't think they were totally effective. However, they are better than literally nothing. (Not so pleasant when they stick to the open wound though, I have to say.) Last year I was converted to the contentious needle and thread approach and found it worked for me. There is literally a barrage of opinion on Compeed and its alternatives on the forum if you take look.
 
Camino(s) past & future
SJPP to SDC 2013/14
SJPP to SDC 2016
Porto to SDC 2017
VdlP Sevilla/Salamanca 2018
#19
Compeeds work very well if used on Hot Spots. As soon as you think you have an issue, stop what you are doing, sit down, clean the effected area and apply the compeed. They come off when they are ready to come off usually a few days later. Taping them as pointed out by Antonious is also a good idea as they can be a little bit goopy and the goop can stick to your socks (especially one applied to the bottom of the heel).
 
Camino(s) past & future
Camino de Santiago, Norte (2016)
Camino Portuguese, Coastal (2018)
#20
Hello :D

Compeed is to be worn on unbroken blisters - never on ruptured ones! You put it on clean dry skin and wear it until it comes of on its own.

If you read the small instruction inside the packet it explains so.
This is how I used them as well. On my last hike, I started to develop a blister around the third day. It was in the early stages so I put a Compeed patch on it. It worked like a wonder. Helped my friend as well when he got a fully developed, unbroken blister. It made all the difference in the world.
 
Camino(s) past & future
2013, 2015, 2017, 2019
#21
In my experience... All blisters are not created equally. As such, they should not be treated equally.

Examples (from my experience)....

Heel Blister: An ill fitting shoe, allows rubbing.
See below...

Toe Blister: One of your other toes stepped on it all day (my favorite way to get a blister)
-switch to sandal with your toes open and free
-lace your boots, first two eyes loose, they a one-over twist, then lace tighter over the ankle
-every morning, grease your toes with Petroleum Jelly so they slip over each other
-use slippery medical tape, like 3M Transpore First Aid Tape (Compeed won't stay on toes)

Bottom of the Heel Blister: Pounding on hard uneven surfaces
-avoid Roman Roads
-pretape with KT tape


My take on Heel Blisters.

Your feet talk to you.... you need to listen.
First, there will be a bit of sensitivity or a “hot spot”.
-The “hot spot” needs to be protected with something like Leukotape Sports Tape.
-You need to watch a video on how to correctly tie your shoes.
-You need to cool your feet more, and also change your sweaty socks for dry ones.

Ok.... You misread (ignored) what your foot was saying, and you now have a Blister (an intact, roof on blister).
Now you need Compeed.
It sticks to your foot (and your sock, and your blister), has some medicinal properties that “promotes” healing, it is slippery on the outside, and has a bit of padding. It is exactly the easy solution you're looking for (pay some money, stick it on, all fixed).
Oh.... but there are problems. Compeed loves sticking to socks. If it get wet, it starts to go gummy. A sweaty sock makes it “wet”. The gummy edges will start to curl, sticks to your sock, curl some more.... The curled edge will rub, and cause a new blister.
So, if you use Compeed, you must cover it with KT Tape. Use lots. KT tape sticks best to it's self. When protecting a heel, wrap it around your ankle with an inch overlap. I found KT tape at Spanish Pharmacies to be very pricey. Buy some on Amazon, and bring it with you.. (it's light to carry)

Next problem. If you take a Compeed off, it will also take off the top of the Blister, and now... you are in really some deep do do.
Solutions... Leave the Compeed on until it falls off (in a shower) after 2-3 days, or soak your foot in water and it will come off. Be patient and gentle. A roofless blister is the last thing you want on the Camino.


If you do rip the roof off... use Compeed (as above) except be very clean. You are about to keep an open wound, in a dirt sweaty boot, all day. That is the same boot that rubbed you, the exact wrong way, to start with.
If you have ripped the top off, you are obviously not good a listening to your feet and you might want to consider a day or two of rest, with some antibiotic cream.



Please correct me if I am wrong, but.... I read once that the EU allows for stickier adhesive then North America. The Spanish Pharmacies band-aids and their Compeed stick a lot better.
 
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Camino(s) past & future
SJPDP-Finisterre X 2, El Norte incompleto
#22
In my experience... All blisters are not created equally. As such, they should not be treated equally.

Examples (from my experience)....

Heel Blister: An ill fitting shoe, allows rubbing.
See below...

Toe Blister: One of your other toes stepped on it all day (my favorite way to get a blister)
-switch to sandal with your toes open and free
-lace your boots, first two eyes loose, they a one-over twist, then lace tighter over the ankle
-every morning, grease your toes with Petroleum Jelly so they slip over each other
-use slippery medical tape, like 3M Transpore First Aid Tape (Compeed won't stay on toes)

Bottom of the Heel Blister: Pounding on hard uneven surfaces
-avoid Roman Roads
-pretape with KT tape


My take on Heel Blisters.

Your feet talk to you.... you need to listen.
First, there will be a bit of sensitivity or a “hot spot”.
-The “hot spot” needs to be protected with something like Leukotape Sports Tape.
-You need to watch a video on how to correctly tie your shoes.
-You need to cool your feet more, and also change your sweaty socks for dry ones.

Ok.... You misread (ignored) what your foot was saying, and you now have a Blister (an intact, roof on blister).
Now you need Compeed.
It sticks to your foot (and your sock, and your blister), has some medicinal properties that “promotes” healing, it is slippery on the outside, and has a bit of padding. It is exactly the easy solution you're looking for (pay some money, stick it on, all fixed).
Oh.... but there are problems. Compeed loves sticking to socks. If it get wet, it starts to go gummy. A sweaty sock makes it “wet”. The gummy edges will start to curl, sticks to your sock, curl some more.... The curled edge will rub, and cause a new blister.
So, if you use Compeed, you must cover it with KT Tape. Use lots. KT tape sticks best to it's self. When protecting a heel, wrap it around your ankle with an inch overlap. I found KT tape at Spanish Pharmacies to be very pricey. Buy some on Amazon, and bring it with you.. (it's light to carry)

Next problem. If you take a Compeed off, it will also take off the top of the Blister, and now... you are in really some deep do do.
Solutions... Leave the Compeed on until it falls off (in a shower) after 2-3 days, or soak your foot in water and it will come off. Be patient and gentle. A roofless blister is the last thing you want on the Camino.


If you do rip the roof off... use Compeed (as above) except be very clean. You are about to keep an open wound, in a dirt sweaty boot, all day. That is the same boot that rubbed you, the exact wrong way, to start with.
If you have ripped the top off, you are obviously not good a listening to your feet and you might want to consider a day or two of rest, with some antibiotic cream.



Please correct me if I am wrong, but.... I read once that the EU allows for stickier adhesive then North America. The Spanish Pharmacies band-aids and their Compeed stick a lot better.
Honestly, I don't know why one would use Compeed on a blister with an intact roof. The hydrocolloid nature of Compeed does nothing when in contact with intact skin. If it's the cushioning of the Compeed that you are looking for put some guaze and tape (I prefer Omnifix) over it.
18DD806E-01E7-4229-826E-34ECC37D6E47.png
 

davebugg

"When I Have Your Wounded" - Dustoff Motto
Camino(s) past & future
Camino Frances...
Sept. 2017: SJPdP to Burgos
Sept./Oct. 2018: SJPdP to Santiago de Compostela
#23
1. The Compeed instructions, and its stated indications for use, clearly state that Compeed is to be used for open/popped/deroofed blisters. It is a hydrocolloid dressing, and that is how these types of dressings are designed to be used. They keep open wounds from infection by bacteria, they create a moist environment that also absorbs excess fluid loss, and it protects the wound from further mechanical damage.

It is less clear about Compeed being used on 'roofed' or skin-covered blisters, although there is little value to doing so, and potential worsening of the blister as well.

2. Using Compeed for hotspots and protected blisters can be done, but it is not ideal. A wrench can be used as a hammer, or a screwdriver can be used as a pry bar, but the right tool does a better job and won't have problems doing it.

3. Anecdotal success using Compeed in an atypical application is not the same thing as it working for everyone when doing so, or even for a good percentage of those using it in an atypical application. I have seen lots of folks attempt to use hydrocolloid coverings like Compeed, Second Skin, Band Aid (yup, they have a version of Compeed) for the ways mentioned above. It worked for some, for others it created more aggravated blistering, even tearing open 'roofed' blisters.

If Compeed was advised for the atypical applications which have been mentioned, the manufacturer would have jumped on that bandwagon long ago in order to expand the sales of the product to a wider base of marketing.

4. While the mechanical source for a blister may be different, the basic cause is the same: shear force friction. Proven strategies for its prevention have been posted before, even very recently. I'd be happy to repost those if so requested. A less likely source of blistering is severe and concentrated mechanical 'pinching' trauma; the type of injury where one gets a piece of loose skin caught in a vise-like force. Many of us have experienced blood blistering as the result of this type of wound.

The medical community has a term, at least in the US, to describe how to approach treatment issues. It is called "Best Practices". This term recognizes that there may be a variety of options which can and have been used for dealing with a medical concern, but that there is a specific protocol for treatment which has seen the best results, which has objectively been measured to produce the best outcome, and which also works to minimize harm to the patient.

Compeed is currently not the 'best practice' for dealing with either hot spots or intact blisters. On the other hand, if all I had on hand was Compeed to place on a hotspot or intact blister, then that's what I would do. Fortunately, I wouldn't be in that situation, but as someone said, for the short term, Compeed is better than nothing.
 
#24
1. The Compeed instructions, and its stated indications for use, clearly state that Compeed is to be used for open/popped/deroofed blisters. It is a hydrocolloid dressing, and that is how these types of dressings are designed to be used. They keep open wounds from infection by bacteria, they create a moist environment that also absorbs excess fluid loss, and it protects the wound from further mechanical damage.

It is less clear about Compeed being used on 'roofed' or skin-covered blisters, although there is little value to doing so, and potential worsening of the blister as well.

2. Using Compeed for hotspots and protected blisters can be done, but it is not ideal. A wrench can be used as a hammer, or a screwdriver can be used as a pry bar, but the right tool does a better job and won't have problems doing it.

3. Anecdotal success using Compeed in an atypical application is not the same thing as it working for everyone when doing so, or even for a good percentage of those using it in an atypical application. I have seen lots of folks attempt to use hydrocolloid coverings like Compeed, Second Skin, Band Aid (yup, they have a version of Compeed) for the ways mentioned above. It worked for some, for others it created more aggravated blistering, even tearing open 'roofed' blisters.

If Compeed was advised for the atypical applications which have been mentioned, the manufacturer would have jumped on that bandwagon long ago in order to expand the sales of the product to a wider base of marketing.

4. While the mechanical source for a blister may be different, the basic cause is the same: shear force friction. Proven strategies for its prevention have been posted before, even very recently. I'd be happy to repost those if so requested. A less likely source of blistering is severe and concentrated mechanical 'pinching' trauma; the type of injury where one gets a piece of loose skin caught in a vise-like force. Many of us have experienced blood blistering as the result of this type of wound.

The medical community has a term, at least in the US, to describe how to approach treatment issues. It is called "Best Practices". This term recognizes that there may be a variety of options which can and have been used for dealing with a medical concern, but that there is a specific protocol for treatment which has seen the best results, which has objectively been measured to produce the best outcome, and which also works to minimize harm to the patient.

Compeed is currently not the 'best practice' for dealing with either hot spots or intact blisters. On the other hand, if all I had on hand was Compeed to place on a hotspot or intact blister, then that's what I would do. Fortunately, I wouldn't be in that situation, but as someone said, for the short term, Compeed is better than nothing.
Ok, you are now not only my go-to shoe guy, with this post you become my go-to blister guy. I didn't have any blisters on this year's camino, thanks in no small measure to your suggestions on shoes (so these two expertises do interact in a positive way!). But I have had blisters in the past and long ago gave up on Compeed. I hate it. But that may be just me. My question, though, has to do with my treatment of choice, which I learned from some Dutch peregrinos on the LePuy route many years ago. Their advice, which I have followed successfully for years, is this -- cut open the blister as soon as you get it, when it is SMALL. Wash it carefully, and use Betadine. If you are walking and not near a good water source and soap, just do your best and bandage it up after using betadine. After you arrive, wash carefully and bandage with gauze and anti-bacterial cream. I have done that for more than 10 years on caminos and have never had a problem. But as you are so fond of pointing out, anecdotal evidence is not scientific evidence. Do you have an opinion on this practice, or have you seen any good medical evidence on this practice?

I know that when I suggest it on the forum, people start warning me about infection, etc, but I can't imagine why the risk of infection with a blister would be any different than the risk of infection that happens every time I slip and fall and cut myself or have other camino mishaps. Then the skin is removed as well, and I just bandage it up using the same steps I use for blisters. But I may be missing someting here! Thanks again for all your help, buen camino, Laurie
 

Anamiri

Active Member
Camino(s) past & future
Camino Frances
#25
1. The Compeed instructions, and its stated indications for use, clearly state that Compeed is to be used for open/popped/deroofed blisters. It is a hydrocolloid dressing, and that is how these types of dressings are designed to be used. They keep open wounds from infection by bacteria, they create a moist environment that also absorbs excess fluid loss, and it protects the wound from further mechanical damage.

It is less clear about Compeed being used on 'roofed' or skin-covered blisters, although there is little value to doing so, and potential worsening of the blister as well.

2. Using Compeed for hotspots and protected blisters can be done, but it is not ideal. A wrench can be used as a hammer, or a screwdriver can be used as a pry bar, but the right tool does a better job and won't have problems doing it.

3. Anecdotal success using Compeed in an atypical application is not the same thing as it working for everyone when doing so, or even for a good percentage of those using it in an atypical application. I have seen lots of folks attempt to use hydrocolloid coverings like Compeed, Second Skin, Band Aid (yup, they have a version of Compeed) for the ways mentioned above. It worked for some, for others it created more aggravated blistering, even tearing open 'roofed' blisters.

If Compeed was advised for the atypical applications which have been mentioned, the manufacturer would have jumped on that bandwagon long ago in order to expand the sales of the product to a wider base of marketing.

4. While the mechanical source for a blister may be different, the basic cause is the same: shear force friction. Proven strategies for its prevention have been posted before, even very recently. I'd be happy to repost those if so requested. A less likely source of blistering is severe and concentrated mechanical 'pinching' trauma; the type of injury where one gets a piece of loose skin caught in a vise-like force. Many of us have experienced blood blistering as the result of this type of wound.

The medical community has a term, at least in the US, to describe how to approach treatment issues. It is called "Best Practices". This term recognizes that there may be a variety of options which can and have been used for dealing with a medical concern, but that there is a specific protocol for treatment which has seen the best results, which has objectively been measured to produce the best outcome, and which also works to minimize harm to the patient.

Compeed is currently not the 'best practice' for dealing with either hot spots or intact blisters. On the other hand, if all I had on hand was Compeed to place on a hotspot or intact blister, then that's what I would do. Fortunately, I wouldn't be in that situation, but as someone said, for the short term, Compeed is better than nothing.


You should give seminars, I would for one would pay to attend! A shame you live so far away. The Oxfam trailwalker people should hire you as a consultant.
 

Anamiri

Active Member
Camino(s) past & future
Camino Frances
#26
Ok, you are now not only my go-to shoe guy, with this post you become my go-to blister guy. I didn't have any blisters on this year's camino, thanks in no small measure to your suggestions on shoes (so these two expertises do interact in a positive way!). But I have had blisters in the past and long ago gave up on Compeed. I hate it. But that may be just me. My question, though, has to do with my treatment of choice, which I learned from some Dutch peregrinos on the LePuy route many years ago. Their advice, which I have followed successfully for years, is this -- cut open the blister as soon as you get it, when it is SMALL. Wash it carefully, and use Betadine. If you are walking and not near a good water source and soap, just do your best and bandage it up after using betadine. After you arrive, wash carefully and bandage with gauze and anti-bacterial cream. I have done that for more than 10 years on caminos and have never had a problem. But as you are so fond of pointing out, anecdotal evidence is not scientific evidence. Do you have an opinion on this practice, or have you seen any good medical evidence on this practice?

I know that when I suggest it on the forum, people start warning me about infection, etc, but I can't imagine why the risk of infection with a blister would be any different than the risk of infection that happens every time I slip and fall and cut myself or have other camino mishaps. Then the skin is removed as well, and I just bandage it up using the same steps I use for blisters. But I may be missing someting here! Thanks again for all your help, buen camino, Laurie
Again , this is my experience, and therefore anecdotal -
1. I try to avoid them by buying the best shoes for me, training in them before I go, pre-taping susceptible areas. Plus walking in flip flops once I've got to my destination for the day and keeping the air around them
2. If I do get a blister, I follow your procedure, dealing with it while it is small, draining, cleaning, antiseptic powder and a clean plaster. works for me.

I rarely get blisters, I got one on the last Camino that healed in a few days.
 

davebugg

"When I Have Your Wounded" - Dustoff Motto
Camino(s) past & future
Camino Frances...
Sept. 2017: SJPdP to Burgos
Sept./Oct. 2018: SJPdP to Santiago de Compostela
#27
......Their advice, which I have followed successfully for years, is this -- cut open the blister as soon as you get it, when it is SMALL. Wash it carefully, and use Betadine. If you are walking and not near a good water source and soap, just do your best and bandage it up after using betadine. After you arrive, wash carefully and bandage with gauze and anti-bacterial cream. I have done that for more than 10 years on caminos and have never had a problem. But as you are so fond of pointing out, anecdotal evidence is not scientific evidence. Do you have an opinion on this practice, or have you seen any good medical evidence on this practice?
For a long time, the thought was to leave the fluid filled blister intact; it would provide some cushioning, protect the wound underneath, and help prevent infections. Most of that has proved not to be the case.

Leaving a blister filled with fluid can actually make healing time longer, the fluid is not necessarily sterile and can have bacteria introduced through micro-abrasive entries that which are too small to readily notice and will seal up fairly quickly after they are opened; this will cause the fluid to become a danger to the underlying tissue.

The recommended treatment now is very similar to what you are doing with a blister.
  1. Wash the area with a disinfecting solution. Betadine is fine. Alcohol works, too.
  2. Cut a slit at the base of the blister along most of the side you are cutting. You want a slit which won't seal up so that any fluid will continue to drain. A small. disposable scalpel blade or a one sided razor blade will do the trick. A scalpel blade will come in a sterile packet. Use a bit of alcohol on either blade. One can also use a lighter to sterilize the blade of the razor.
  3. Leave the 'roof' of the blister if possible; it will help protect the wound underneath. You just want to make sure fluid doesn't build up again.
  4. If the 'roof' has been torn and is just flapping around, carefully trim it off. A loose flap of skin can cause more damage to the wound by rucking up and rubbing it.
  5. Carefully put an antibiotic cream directly on the roof of the deflated blister. This does two things: it provides a bit of prophylaxis against bacteria. It also will keep adhesive from sticking to the roof of the blister.
  6. Make sure the area surrounding the blister is free of debris and body oils (alcohol).
  7. I like to apply tincture of benzoin to the skin surrounding the blister. This increases the adhesive holding power of the dressing that will be placed on the blister. Tincture of Benzoin comes in tiny ampoules so it takes up little space in a first aid pouch.
  8. Any number of dressing applications can work here. I happen to favor Molefoam. A bit of absorbent pad goes directly over the blister. A circular cut piece of Molefoam goes over that and to the surrounding skin with the benzoin on it. Moleskin, Leukotape P, Omnifix, white athletic tape, etc. can also work.
  9. At the end of the day, carefully remove the blister dressing. There should be no tugging or pulling of the blister 'roof' because of the precautions previously taken. Carefully evaluate the wound for any evidence of infection or additional trauma. Showering or swimming is fine; when done re-apply antibiotic ointment and dressing if you will be walking around in the evening. If you can remove the dressing while sleeping, that will help the healing process.
  10. Any adhesive for medical applications can have allergic properties to an individual. So after removing the dressing, check your skin that was in contact with the adhesive for signs of redness, irritation, rash, etc. Any indication of an allergic reaction or skin breakdown must be looked after. It can be as simple as changing the adhesive bandaging that you are using.
 
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Camino(s) past & future
Walked from O'Cebreiro to Santiago in 2016
Planning to walk from Burgos this June, 2018
#28
Ok, you are now not only my go-to shoe guy, with this post you become my go-to blister guy. I didn't have any blisters on this year's camino, thanks in no small measure to your suggestions on shoes (so these two expertises do interact in a positive way!). But I have had blisters in the past and long ago gave up on Compeed. I hate it. But that may be just me. My question, though, has to do with my treatment of choice, which I learned from some Dutch peregrinos on the LePuy route many years ago. Their advice, which I have followed successfully for years, is this -- cut open the blister as soon as you get it, when it is SMALL. Wash it carefully, and use Betadine. If you are walking and not near a good water source and soap, just do your best and bandage it up after using betadine. After you arrive, wash carefully and bandage with gauze and anti-bacterial cream. I have done that for more than 10 years on caminos and have never had a problem. But as you are so fond of pointing out, anecdotal evidence is not scientific evidence. Do you have an opinion on this practice, or have you seen any good medical evidence on this practice?

I know that when I suggest it on the forum, people start warning me about infection, etc, but I can't imagine why the risk of infection with a blister would be any different than the risk of infection that happens every time I slip and fall and cut myself or have other camino mishaps. Then the skin is removed as well, and I just bandage it up using the same steps I use for blisters. But I may be missing someting here! Thanks again for all your help, buen camino, Laurie
Hi,
When you say "cut open" a blister, do you use a needle to drain it? Can you explain in more detail?
Thanks,
Lynne
 
Camino(s) past & future
Walked from O'Cebreiro to Santiago in 2016
Planning to walk from Burgos this June, 2018
#29
For a long time, the thought was to leave the fluid filled blister intact; it would provide some cushioning, protect the wound underneath, and help prevent infections. Most of that has proved not to be the case.

Leaving a blister filled with fluid can actually make healing time longer, the fluid is not necessarily sterile and can have bacteria introduced through micro-abrasive entries that which are too small to readily notice and will seal up fairly quickly after they are opened; this will cause the fluid to become a danger to the underlying tissue.

The recommended treatment now is very similar to what you are doing with a blister.
  1. Wash the area with a disinfecting solution. Betadine is fine. Alcohol works, too.
  2. Cut a slit at the base of the blister along most of the side you are cutting. You want a slit which won't seal up so that any fluid will continue to drain. A small. disposable scalpel blade or a one sided razor blade will do the trick. A scalpel blade will come in a sterile packet. Use a bit of alcohol on either blade. One can also use a lighter to sterilize the blade of the razor.
  3. Leave the 'roof' of the blister if possible; it will help protect the wound underneath. You just want to make sure fluid doesn't build up again.
  4. If the 'roof' has been torn and is just flapping around, carefully trim it off. A loose flap of skin can cause more damage to the wound by rucking up and rubbing it.
  5. Carefully put an antibiotic cream directly on the roof of the deflated blister. This does two things: it provides a bit of prophylaxis against bacteria. It also will keep adhesive from sticking to the roof of the blister.
  6. Make sure the area surrounding the blister is free of debris and body oils (alcohol).
  7. I like to apply tincture of benzoin to the skin surrounding the blister. This increases the adhesive holding power of the dressing that will be placed on the blister. Tincture of Benzoin comes in tiny ampoules so it takes up little space in a first aid pouch.
  8. Any number of dressing applications can work here. I happen to favor Molefoam. A bit of absorbent pad goes directly over the blister. A circular cut piece of Molefoam goes over that and to the surrounding skin with the benzoin on it. Moleskin, Leukotape P, Omnifix, white athletic tape, etc. can also work.
  9. At the end of the day, carefully remove the blister dressing. There should be no tugging or pulling of the blister 'roof' because of the precautions previously taken. Carefully evaluate the wound for any evidence of infection or additional trauma. Showering or swimming is fine; when done re-apply antibiotic ointment and dressing if you will be walking around in the evening. If you can remove the dressing while sleeping, that will help the healing process.
  10. Any adhesive for medical applications can have allergic properties to an individual. So after removing the dressing, check your skin that was in contact with the adhesive for signs of redness, irritation, rash, etc. Any indication of an allergic reaction or skin breakdown must be looked after. It can be as simple as changing the adhesive bandaging that you are using.
You are such a great help. As I read #8, I just want to clarify...You put moleskin, tape, etc over the blister so it covers the surrounding area. You don't put anything else over the blister itself? And the tape will not adhere to the roof of the blister if I put an antibiotic cream on it?
Do you use a pretty good size piece of adhesive?

Also, I haven't used tape before, but I would worry that the edges my curl and irritate my skin. Is this a concern?
Lynne
 

Anamiri

Active Member
Camino(s) past & future
Camino Frances
#30
I have really sharp but tiny embroidery scissors that I use instead of a needle, I do a tiny wee snip at the side of the blister, so that I can leave the roof relatively intact but drain out the fluid. Sounds like davebugg uses a blade. I find a needle doesnt make a big enough hole, plus the scissors can be used for other things as well.

Though when my sister got blisters, she freaked out and wouldnt let me touch her toes with the wee scissors, and preferred persevering with a needle. (The tips of the scissors are needle sharp anyway).


Edited to add. I cover the dressing with a piece of kinesiology tape (personal choice), it's soft and stretchy and you can smooth it out, and round off the corners. It stops the dressing sticking to socks or curling. Just washes off in the shower.
I usually use it for pre-taping to avoid blisters.
 
Last edited:
Camino(s) past & future
SJPDP-Finisterre X 2, El Norte incompleto
#31
Also, I haven't used tape before, but I would worry that the edges my curl and irritate my skin. Is this a concern?
Lynne
That's why I like Omnifix. It's so thin and flexible, and adheres well. It has a paper backing that you peel off, and when you cut it you can round off the corners to keep it from having a corner that mighty peel up.
 

davebugg

"When I Have Your Wounded" - Dustoff Motto
Camino(s) past & future
Camino Frances...
Sept. 2017: SJPdP to Burgos
Sept./Oct. 2018: SJPdP to Santiago de Compostela
#32
You are such a great help. As I read #8, I just want to clarify...You put moleskin, tape, etc over the blister so it covers the surrounding area. You don't put anything else over the blister itself? And the tape will not adhere to the roof of the blister if I put an antibiotic cream on it?
Do you use a pretty good size piece of adhesive?

Also, I haven't used tape before, but I would worry that the edges my curl and irritate my skin. Is this a concern?
Lynne
Yes, the dressing covers the blister, and enough of the surrounding to allow the adhesive to keep the dressing in place while walking. I always ere on the side of having too much tape than is needed rather than too little.

The cream will keep the adhesive from sticking to the blister, but there is also an absorbent pad between the skin and the tape as well. The antibiotic also comes in an ointment, which has a base that is sort of like vaseline, which is even more effective at keeping the adhesive at bay :)

A couple of things about tape and better adhesion.

1. It is important to not touch the adhesive surface of a tape prior to application as it will pick up trace contaminants which will make it less 'sticky'.

2. Always try to thoroughly clean the area of the foot with a small amount of alcohol or alcohol based hand sanitizer and let it dry.

3. A thin application of tincture of benzoin to the skin to which the adhesive will be placed will multiply the holding power of an adhesive.

4. When the tape is applied, spend a bit of time rubbing the entire area of the tape. This creates friction which will heat the adhesive and make it adhere better.

5. Always cut rounded edges to a tape that you will apply. This helps prevent edges from curling up.

Hope this helps :)
 

davebugg

"When I Have Your Wounded" - Dustoff Motto
Camino(s) past & future
Camino Frances...
Sept. 2017: SJPdP to Burgos
Sept./Oct. 2018: SJPdP to Santiago de Compostela
#33
I have really sharp but tiny embroidery scissors that I use instead of a needle, I do a tiny wee snip at the side of the blister, so that I can leave the roof relatively intact but drain out the fluid. Sounds like davebugg uses a blade. I find a needle doesnt make a big enough hole, plus the scissors can be used for other things as well.

Though when my sister got blisters, she freaked out and wouldnt let me touch her toes with the wee scissors, and preferred persevering with a needle. (The tips of the scissors are needle sharp anyway).


Edited to add. I cover the dressing with a piece of kinesiology tape (personal choice), it's soft and stretchy and you can smooth it out, and round off the corners. It stops the dressing sticking to socks or curling. Just washes off in the shower.
I usually use it for pre-taping to avoid blisters.
The scissors can work well also. They will cut a big enough slit to keep the opening from sealing back up. That is why using a needle to puncture the blister to drain the fluid is no longer the method of choice, because it frequently will seal back up and refill.

To overcome the resealing, the technique of threading a piece of thread through the blister was developed. Because of the increased possibility of infection, that, too, is no longer recommended. Cutting a slit works better and has been shown to reduce the risk of infection to the wound.
 
#34
Hi,
When you say "cut open" a blister, do you use a needle to drain it? Can you explain in more detail?
Thanks,
Lynne
I just take my small scissors and cut off as much of the top covering as one snip takes. That way there is a hole that is too big to close up. I find that using a needle to drain it means that the small pinhole will close up by itself and the blister reforms. But I would do what @davebugg says, he is far more knowledgeable.
 
Camino(s) past & future
SJPDP-Finisterre X 2, El Norte incompleto
#35
I just take my small scissors and cut off as much of the top covering as one snip takes. That way there is a hole that is too big to close up. I find that using a needle to drain it means that the small pinhole will close up by itself and the blister reforms. But I would do what @davebugg says, he is far more knowledgeable.
Do you sterilize the nail scissors in some way?
 

Anamiri

Active Member
Camino(s) past & future
Camino Frances
#36
I try to deal with blisters in an albergue where we have acess to a clean environment, hot water etc.
 
#37
Do you sterilize the nail scissors in some way?
No, I don't, but I use a lot of betadine to wash it out. Maybe I've just been lucky, but I've never had a problem. I will modify my blister-cutting to do what @davebugg recommends, which is to leave as much of the top cover skin on the blister to aid the healing process. But having a big enough cut so that the blister doesn't close itself up and refill is what has been the key for me.

I try to deal with blisters in an albergue where we have acess to a clean environment, hot water etc.
I agree that is the best, but I have found that it is far more important for me and my feet to deal with the blister the minute I notice it, which usually means it is no bigger than the size of a lentil. Walking with a blister forming for hours just means that it will get bigger and bigger and just that much harder to get rid of.
 

davebugg

"When I Have Your Wounded" - Dustoff Motto
Camino(s) past & future
Camino Frances...
Sept. 2017: SJPdP to Burgos
Sept./Oct. 2018: SJPdP to Santiago de Compostela
#38
peregrina2000: When using the small scissors, one snip makes a sufficiently large opening, just as you've been doing. It should leave the skin roof still firmly anchored.

For those wondering about the size of a scissor to use, I have a pair of these scissors, and they would work well for the task.

I generally don't carry scissors with a backpack, which is why I was focused on a scalpel blade, which I do carry. The type of blade I am talking about is similar to this one on Amazon. You can either leave the handle as is, or cut the handle down (which is what I do).

Anamiri: You make a good point re: waiting to treat until you are at your end of the day destination. I think there are two conditions that would make that workable:

1. If you find that you can stabilize the blister from becoming more aggravated. You want to keep the blister as small as possible. If treated like a bad 'hot spot', then that might work. The blister needs to be protected from continued friction. Keep monitoring the blister to make sure it is stabile as you continue on. Frequent breaks to take off your shoe and inspect the area for increasing pressure, tenderness and growth. You won't be able to see the blister itself, because you will have dressed it.

2. Discomfort. A lot of times a fluid filled blister hurts more to walk on than one that is treated. The extra pressure of the fluid against the raw tissue can make nerve endings sing an exquisite chorus. If there is little discomfort, then it can be ok to treat at the end of the day.

The main concern regarding infection is from fluid in the blister becoming contaminated and then purulent, which can then break down the underlying tissue. Surface bacteria and contaminants are easily and sufficiently dealt with doing blister treatment in the field. Everyone should carry a small travel bottle of hand sanitizer, and that is sufficient to cleanse and disinfect the area to be treated. It will also 'degrease' the area of the skin to which the dressing (tape, moleskin, etc) will be affixed.
 

Anamiri

Active Member
Camino(s) past & future
Camino Frances
#39
I rarely get blisters myself, the pre-taping usually works for me but often need to assist others. The worst/funniest blister incident I had was in the middle of the night during an Oxfam trailwalk event, dealing with a teammates blister. I accidentally dropped the scissors, and everything else in the mud, so we wiped hand sanitiser over them. At least the antiseptic powder and the dressing were protected by packaging.
While we were dealing with her feet, and helping her balance while we did this, another teammate stood on her sock (the one she's taken off) and pressed it into the mud
 

MarkPR

New Member
Camino(s) past & future
Frances (2016)
#41
Throw that crap away. People seem to fall in love with it and leave it on until it falls off, but the blisters never heal because they're enclosed in a wet micro-environment. Use it to get to the albergue and then take it off. Let your feet air out. Dryness is what's needed.
 


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