Injury resulting from freezing of the tissues in the body is called frostbite. Commonly affected parts are hands and feet followed by nose, ears and shins.
This condition occurs when the skin is exposed to extremely cold temperature lower than -10 degree centigrade.
Frost bite injury occurs in four phases:
• When the tissues are exposed too cold environment there is increased blood viscosity, microvascular constriction and plasma leakage.
• Ice crystals forms in the extra-cellular space.
• Between the injured and non-injured tissues arterivenous shunting occurs resulting in sludging of microvasculature erythrocyte that causes stasis, coagulation and formation of thrombus.
• After the formation of thrombus there occurs inflammation, hypoxia and tissue necrosis.
commonly found in
People living in tropical climate are at more risk.
Higher incidences are in males. Commonly affected age group is 30-50 years.
Exposure of body part to cold environment for prolonged period time is the major reason for occurrence of frostbite.
Following are the risk factors:
• Taking medicines called beta-blockers.
• Having Raynaud’s disease.
• Pricking sensation and numbness in the affected part.
• Aching or throbbing of the affected area.
• Affected skin feels unusually firm or waxy.
• Hard, pale, and cold skin of the affected part.
• Blister formation.
• Generally history of the patient is asked related to cold exposure or any medical history before cold injury.
• Vital signs should be noted such as pulse, blood pressure, respiratory rate and temperature to exclude other medical illness.
• Narcotic pain killers.
• IV fluids in case of dehydration.
• Tetanus booster is given if required.
• Ibuprofen to reduce inflammation.
• As soon as possible get into a warm room.
• Avoid walking on affected feet or toes.
• Do not massage the affected part.
• Don’t use a heating pad, heat lamp, or the heat of a stove, fireplace, or radiator for warming. Numbness of the affected areas make them more liable to get burnt.
• Immerse the affected area in warm water.
• If warm water is not available, try to warm the affected area using body heat.
Mild frostbite symptoms have good prognosis without any complications. Infection of the frostbitten area causes complications, amputation may be needed.
• Permanent numbness of affected area.
• Frostbite arthritis because of the change in the cartilage between the joint.
• Burning, itching, redness and swelling as if frozen.
• Pricking as from needles.
• Worse after alcohol.
• Itching occurs in bed.
• Blisters formation which bleed very easily.
• The skin is extremely sensitive to cold air.
• Better by warm application, warm wraps and heat.
• Worse in cold air, winter, and cold application.
• Suppuration can occur.
• Ulceration leading to gangrene.
• Severe burning sensation worse at night and during sleep.
• Sensitive to touch.
• Severe excoriation of the affected part.
• Dryness of the skin.
• Severe pricking, shooting, burning pain.
• Worse open air, cold application and cold weather.
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