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'Trench foot' is a serious disorder of the lower limb, involving damage to the skin, nerves, and muscle, previously described in World War I soldiers during trench warfare. We present a rare and unusual case of ‘trench foot' sustained at home in a 20-year-old female. Case Report A 20-year-old woman presented to the Plastic Surgery department with pain and numbness affecting both feet, following failed trials of antibiotics. She managed her symptoms at home by immersing her feet in ice baths for 18-23 hours per day. She was tachycardic with raised inflammatory markers. Examination revealed breakdown of the skin bilaterally, with full thickness eschar. MRI showed extensive subcutaneous oedema and myositis. Initial surgical plan consisted of antibiotics and debridement of necrotic tissue with a view to grafting the skin later. Intra-operative findings included necrosis of the subcutaneous tissues and muscles. The patient deteriorated post-operatively with sepsis and underwent urgent Guillotine-style bilateral amputations. She was discharged home 18 days later. Discussion 'Trench foot' can be mistaken for soft tissue infections or frostbite. It is attributed to vasoconstriction followed by neurovascular changes and repeated cycles of thawing and freezing, acquired above freezing temperatures, unlike frostbite which occurs below freezing temperatures. The patient was initially reviewed by non-specialist teams without a clear diagnosis and sustained more pervasive tissue destruction than was originally apparent on examination. Prevention remains the best cure for ‘trench foot'. It is therefore important to familiarise ourselves with this rare disease. Where prevention or early detection is not possible, amputation can reduce the morbidity and mortality of the ensuing sepsis.

1479 Trench Foot: A Rare and Unusual Presentation of a World War I Disease