The OP has already dealt with her blisters, and many of the posts have been on target regarding treatment. The method of treating a blister in a post by arturo with the video from NOLS, provides relevant advice which is still among the best practices for blister treatment. Posts made by Morgan and Andrea also contained good information,
Let me summarize the 'best practices' for blister treatment.
1.This assumes a new blister (discovered during a walk or at the end of a day) whether it is intact or 'deroofed'.
2. The individual or attending samaritans are comfortable and willing to do treatment. If a pilgrim decides to seek professional help -- whether it is needed of not -- the 'patient' decides what assistance makes them less anxious and more secure.
3. Beyond those stipulations, self-treatment of a blister is fairly straight forward.
There are two broad levels of hygiene for wound care. This is a very broad generalization for the purpose of illustration.
1. Sterile field. This level of hygiene is required for tertiary treatment of an open body cavity or for the final 'cleaning' and repair of open tissue wounds requiring sutures. This level of hygiene is primarily done in a medical facility. If one is providing first aid treatment in the field to someone with a wound requiring the above level of hygiene, the first and primary concern is with stabilizing the patient and controlling bleeding, not achieving a sterile field of treatment. Maintaining personal protection from body fluids will be more relevant than trying to keep first aid treatment 'clean'. The medical facility will deal with the potential for infections when they receive the patient.
2. Basic aseptic technique. This is a method to prevent pathogens from being introduced into a wound during routine care. It is based on handwashing, disinfection, and the proper application of a dressing to an open sore or wound where the skin layers are damaged. This level of hygiene can be achieved in the 'field' under most conditions, apart from situations of providing first aid to serious injuries while awaiting transport to a medical facility.
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.
- 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.
- If the blister has 'deroofed', then trim off any skin tag which might flap back into the raw open wound.
Preparing the wound for dressing involves two steps.
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
The primary issue is that whatever method of taping, adhering a pad, taping a covering over the pad, etc, getting it to stick and remain in place -- and not sweat or prematurely roll off or wear off -- can be a 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. Do not put on the wound. This will multiply the holding power of the adhesive that is used.
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, the NOLS video above 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 deroofed 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 deroofed, 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, recleanse the wound, shower, cleanse, apply ointment, and redress for evening activities. At bedtime, remove the dressing, recleanse 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. If the wound looks 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.
