Tissue damage from cold

Description

Frostbite or tissue damage from cold. It occurs when the skin and the underneath tissue frozen due to the exposure to an extreme cold. The exposure to cold first causes the first degree frostbite, i.e. reversible skin irritation. If warming does not happen, this condition will grow into frostbite. The frostbites affect the fingers and toes and face and appear in those who do not feel consequences of the first degree frostbites or in those who cannot or do not want to go away from the cold. This disorder is frequently associated with alcoholism, psychiatric disorders, diabetes, smoking and previous frostbites.

Symptoms

At the beginning pricking, then numbness, pulsating and pain. Later, sensation disappears due to death of nerves. Skin looks hard and pale. Skin with serious frostbite can have blisters,be dark colored (represents gangrene). Bones, muscles and tendons are being damaged.

Overview

Anamnesis and physical examination will be done. The examinations may be done to determine extent of the damage.

Tests

X-rays

Specialists

Orthopedics, Surgery

Therapy

Remove the patient from the cold and protect frozen spots from further damaging. If there is a risk of new freezing, it should not warm the injured spots. The injured parts should be bandaged with a sterile dressing. Frozen parts should not be used if possible. Warming of the frostbites can be done by placing in warm water (from 40 to 42 C⁰). Severe painful pricking sensation, swelling and changes in skin colour may occur during warming up. The warming up is finished when skin softness and sensitivity are restored. After warming up, you should bandage the skin with sterile gauze and separate the hand fingers and toes.A hospital treatment consists of constant warming up, bandaging, dead tissue removal (debridement) and surgery. A dead tissue removal is not done aggressively, since the tissue, which at the beginning seemed dead, can sometimes be saved with the time and treatment.