Beginner Backpack Workshop – BlistersBackpacking 入門講座 – 水泡成因，預防與護理

This article is based on what I presented in the Beginner Backpack Workshop held by Appalachian Mountain Club, Delaware Valley Chapter, April 22, 2006.

Cause of Blisters

The cause of blisters is friction. With enough rubbing, the tough epidermis which has been resisting abrasion separates and fluid fills in the space. A blister therefore forms.

A general guideline to prevent blisters from happening is to keep our feet cool and dry, because both heat and moisture increase friction. Heat makes the feet swollen and moisture softens the skin.

Prevention

The best way to deal with blisters is to prevent them, and prevention can take place before heading out for a trip:

1. Find a pair of boots that fits your feet snugly.

2. Condition your feet: the best discipline is probably to walk in your bare feet as much as possible, or at least use your feet as much as possible.

3. Cover the blister-prone areas with athletic tape, moleskin, or other material.

4. Select a sock system that suits you.

During a trip, the following are what you can do:

1. Let your feet breathe more whenever you have a chance. For example, when taking a snack break, lunch break or whatever break that is longer than several minutes long, take your feet out of your boots to cool them down. Never underestimate these few minutes of air cooling process, because it in fact reduces the degree of swelling significantly.

2. Prepare two pairs of socks and rotate them. If your feet tend to sweat a lot or you are hiking in on an extremely hot and humid day, it’s nice to prepare an extra pair of dry socks to replace those damp ones on your feet. Once you rotate them, you can hang those wet ones on your pack to air dry them. Just make sure none of your teammates gets too close to them!

3. Elevate your feet when you have a longer break. Foot elevation is to help better blood circulation, which will take heat away from the feet more efficiently and reduce the swelling.

4. Remove dust and small rocks out of socks and boots. Keeping your boots and socks as clean as possible is another way to reduce unnecessary rubbing. Therefore when you feel dust and rocks touch your delicate feet, spot them and remove them.

5. Give your feet a break by hiking in sports sandals occasionally. Many people are skeptical about hiking in sports sandals, but if your feet are good and the trails are well-maintained, I don’t see why you can’t hike in sports sandals, especially modern sports sandals have good cushion and stability. I, myself, have backpacked in sports sandals numerous times and I enjoyed the air flow through my feet. Hiking in sports sandals gives your boots and socks a rest especially in extremely humid days. I’ve tried Teva, Chaco, and Keen Footwear and they are all great. Keen Footwear sandals cover the toe areas, which might make hikers more comfortable if they are concerned about protection. However, since Keens cover more area and make more contact with the feet, my feet usually get more sweaty in them than in Teva or Chaco and I got blisters at the sides at times. (To avoid it, I can wear a pair of thin liners or tape those areas before putting my feet in the sandals.) Most people bring sports sandals as camp shoes, and they are handy for river crossing, so why not give them a shot next time?

When There Are Hot Spots/Redness/Small Blisters

When you feel there are hot spots on your feet or when you inspect your feet during a break and spot a faint redness or a small blister, DO SOMETHING! Don’t naively think they will go away and it’s certainly not the time for you to play a hero.

You should cover the area to prevent further rubbing, and the material you can use include athletic tape, surgical tape, band-aid, moleskin, Spenco Second Skin, and so on. Go to a local drugstore, you will find plenty on the counter. Some hikers prefer duct tape, but I’ve never done that before because duct tape seems to be too sticky to me.

When There Are Big/Painful Blisters

I hope you don’t have to come this far, but if you really get a big blister and it causes pain or unease and it prevents you from walking straight, drain it and cover the area. How? Here are the steps:

1. Clean the area.
2. Sterilize a needle and use it to make holes around the base of the blister.
3. Drain the blister by gently compressing the blister.
4. Apply antibiotic ointment to the area, and cover it with gauze.
5. Cut a donut-shaped piece of moleskin, molefoam, etc, and center the paddling over the area.
6. Tape the area.
7. Clean daily and monitor for signs of infection.

Reference


這篇文章是根據我在四月二十二日，由Appalachian Mountain Club, Delaware Valley Chapter 舉辦的Backpacking 入門講座的講稿寫成的。

水泡成因

摩擦是水泡的成因。持續的摩擦讓頑強抵抗的表皮與下層皮膚脫離，液體因此湧入該空間，而產生水泡。

一般來說，預防水泡，必須保持雙腳乾燥以及涼爽。因為燥熱以及濕悶都是增加摩擦的原因。燥熱讓雙腳更加臃腫，而濕悶讓皮膚表層軟化。

預防

對抗水泡的最好作法，還是在於預防。預防可以從平常就開始做起：

1. 好好找一雙合腳的登山鞋。
2. 訓練雙腳：最有效率的方法不外乎盡量赤足走路，要不然，至少也要多走路才好。
3. 找出適合自己雙腳的襪子穿著配套。
4. 行前用膠布、貼布（athletic tape、moleskin）覆蓋容易產生水泡的部位。

行程進行間，也可以採取以下方式預防水泡：

1. 有機會就讓雙腳透透氣。舉例來說，一天當中，總有幾次停下來休息的機會，喝喝水、吃吃點心、喘口氣，如果時間足夠，脫下登山鞋，讓雙腳和登山鞋都有機會呼吸新鮮空氣。就算休息時間只有幾分鐘也好，不要小看這短短的數分鐘，已經足夠讓雙腳消腫好一些的了。

2. 準備兩雙以上的襪子，輪流替換。如果你的雙腳屬於容易流汗的類型，或是行走當天的天氣濕熱不堪，最好還是總有雙乾燥潔淨的襪子，可供替換下腳下那雙濕悶的襪子。替換之後，可以把換下來的襪子掛在背包上，讓它們曬曬太陽，吹吹風，等待下一次的替換。唯一要注意的事，可能是注意別讓隊友靠太近了。

3. 抬高雙腳，讓血液循環暢通。如果有比較長時間的休息，像是午餐時間等，可以抬高雙腳，促進血液流經雙腳的速度，可以增進散熱的效率，減少雙腳的腫脹程度。

4. 移除蹦進雙腳的泥沙和小石子。盡可能保持鞋襪的乾淨清爽，也是減少不必要摩擦的不二法門。所以，如果感覺到腳下不時有泥沙和石塊和雙腳磨蹭，花些時間清理一下。

5. 不時穿著運動涼鞋健行，給雙腳以及登山鞋歇息的機會。很多人質疑「真的可以穿運動涼鞋走山路嗎？」如果你走路的姿勢正確，雙腳健康，步道狀況良好，我看不出來為什麼不能穿運動涼鞋健行，更何況，現在運動涼鞋的製作技術優良，很多款式都具有相當好的緩衝性，以及抓著力。我個人就有多次穿著運動涼鞋backpacking的經驗。基本上，尤其在濕熱的氣候下，偶爾穿穿運動涼鞋走路，還真的讓雙腳輕鬆不少。我曾經試過的品牌包括Teva、Chaco、和Keen Footwear，使用的經驗都還算不錯。值得一提的是Keen Footwear的設計把腳指頭的區域包裹起來，這點讓很多對於涼鞋的保護功能有疑慮的人，放心不少。可惜的是，Keen Footwear的涼鞋包裹的區域太多，接觸腳的面積比其他兩品牌來的多，我的穿著經驗是，雙腳比較容易流汗，偶爾兩側接觸的地方也會生成水泡（這點可以利用穿著極薄的排汗襪，或是使用貼布來預防）。很多人本來就會帶一雙運動涼鞋做為營地鞋之用，同時運動涼鞋也是穿渡溪流的好選擇，所以為何不給它們多一個健行的機會呢？

感覺腳上有異常紅熱，或發現小水泡生成

當感覺到腳上有異常的紅熱現象，或是看到小水泡已然生成，請採取行動！不要天真的認為，這些症狀過不多時就會消失，同時也不要逞強地不去處理。

你應該覆蓋該區域，以免其持續地摩擦。可以使用的覆蓋材料包括膠布、貼布、紗布等等（athletic tape、surgical tape、band-aid、moleskin、Spenco Second Skin），基本上到一家藥局去參觀一下，就會發現，可供選擇的材料還真多的讓你眼花撩亂。有的人說大力膠帶（duct tape）相當好用，個人是沒有這個經驗，因為實在怕大力膠帶太黏了，

產生造成雙腳疼痛、不適的大水泡

我希望你永遠不需要走到這一步，但是如果大水泡真的產生了，造成雙腳的疼痛以及不適，開始妨礙走路的時候，就是該「放水」，並且做一些基本護理的時候了。怎麼做？以下幾個步驟讓你參考：

1. 清潔水泡以及周遭區域。
2. 消毒針頭，以該針頭在水泡底部，刺出幾個小孔。
3. 輕輕擠壓水泡，讓液體流乾。
4. 在該區域塗抹抗菌軟膏（antibiotic ointment），然後以紗布覆蓋。
5. 將貼布剪成甜甜圈狀，瞄準水泡為中心貼上。
6. 將該區域的紗布、貼布以透氣膠帶固定。
7. 每天清潔並且觀察恢復情形，並注意是否有感染發炎的情況發生。

參考資料：

Tod Schimelpfenig and Linda Lindsey. NOLS Wilderness First Aid. Second edition.
Frank Hubbell. SOLO’s Field Guide to Wilderness First Aid.