frostbite

(chilblains), injury to the tissue caused by exposure to cold, usually affecting the extremities of the body, such as the hands, feet, ears, or nose. Extreme cold causes the small blood vessels in the extremities to constrict. The blood circulates more slowly and stagnation results. Eventually the body fluids may freeze. The condition is aggravated by tight clothing, physical inactivity, and dampness. Severe frostbite that is not treated may result in gangrene; amputation of the affected part may be necessary. See first aidfirst aid,
immediate and temporary treatment of a victim of sudden illness or injury while awaiting the arrival of medical aid. Proper early measures may be instrumental in saving life and ensuring a better and more rapid recovery.
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Frostbite

(also called congelation), damage to body tissues as a result of cold. Frostbite usually affects the lower extremities; less frequently, it affects the upper extremities, the nose, and the ears. It can develop at such relatively mild freezing temperatures as –3° to – 5°C. It can even set in at nonfreezing temperatures; this usually occurs when the body’s resistance is decreased by such factors as starvation, intoxication, or loss of blood from a wound. Wind and increased humidity promote the development of frostbite.

The body reacts to cold with a reflex spasm of the peripheral blood vessels. The cold also acts directly on the tissues, lowering the temperature of the tissues and disrupting local metabolism. The changes that develop in the tissues depend on the intensity of the cold and on the duration of exposure. Four degrees of frostbite are distinguished. In cases of first-degree frostbite, the affected area first reddens and then becomes white and numb. Occasionally, these symptoms are accompanied by a tingling sensation. After being thawed out, the affected area of the skin reddens and swells; slight pain and a burning sensation are noticeable. Within two to three days all symptoms disappear completely.

Second-degree frostbite is characterized by more serious disorders of blood circulation, although any changes in the blood vessels are still reversible. The skin is markedly pale, becoming purple upon thawing, and edema extends beyond the frozen areas. Blisters filled with clear or bloody fluid appear.

Third-degree frostbite develops as a result of intense cold or prolonged exposure to cold. Blood circulation is severely disrupted, and the skin becomes blue-purple (occasionally, black) after thawing. The blisters are filled with a bloody dark brown fluid. The affected area is completely numb during the first days after freezing; subsequently, severe pain arises. In fourth-degree frostbite, necrosis extends through the soft tissues to the bones.

First aid for frostbite is directed toward the most rapid restoration of blood circulation in the affected area. First- or second-degree frostbite in the hands or feet is treated by heating the frozen part in warm water (18°–20°C), lightly massaging the area, and then slowly increasing the water temperature to 37°–38°C. Massage is not recommended when blisters are present. Rubbing with alcohol and applying a dry, sterile bandage while the patient is given hot tea and a small quantity of alcohol to drink are also helpful. To prevent infection in second-, third-, or fourth-degree frostbite, tetanus antitoxin, antibiotics, and other substances are administered. In cases of extensive third- and fourth-degree frostbite, the affected area is covered with sterile cloths and bound, but not tightly, after which the patient is transported to surgery.

Frostbite can be avoided by wearing warm, loose clothing and comfortable, waterproof footwear equipped with insoles. Measures should be taken to prevent foot perspiration, and hot food should be eaten at regular intervals. Protective greasy cream should be applied to the face, ears, and lips.

REFERENCE

Ar’ev, T. Ia. Ozhogi i otmorozheniia. Leningrad, 1971.

D. A. VELIKORETSKII

frostbite

[′frȯst‚bīt] (medicine) Injury to skin and subcutaneous tissues, and in severe cases to deeper tissues also, from exposure to extreme cold.

frostbite

1. destruction of tissues, esp those of the fingers, ears, toes, and nose, by freezing, characterized by tingling, blister formation, and gangrene 2. NZ a type of small sailing dinghy

frostbite

[frost´bīt] injury to tissues due to exposure to cold. Usually the first areas of the body to freeze are the nose, ears, fingers, and toes. The flesh feels cold to the touch, and frozen parts become pale and feel numb. There may also be some prickly or itchy sensation. A person suffering from frostbite may feel no warning pain. In mild cases, proper treatment can rather quickly restore normal circulation of blood. In more serious cases the area may become painfully inflamed, and blistering may follow. Especially severe frostbite can cause death of the injured tissues and gangrene" >gangrene.
Mild frostbite usually appears as a shallow, blanched wheal on the nose, ears, fingers, or toes. After rewarming, the area is slightly reddened for several hours and then resumes a normal appearance. If the frostbite is more severe, deeper tissues are affected and the area appears waxy and feels doughlike to the touch. With rewarming, the area becomes edematous and the patient feels itching, burning, and deep pain. Later on, mild edema may remain and the skin becomes mottled, cyanotic, or red without blistering. Over the following weeks the pain and edema should subside, but the skin may peel and the patient may experience increased sensitivity to cold in that area until healing is complete.
Blistering occurs in deeper frostbite. The vesicles may contain pink or clear fluid that has leaked from damaged cells and tissues. Eventually the vesicles contract and dry out, leaving an eschar that sloughs off and exposes new skin underneath if there has been adequate circulation to the part.
Severe frostbite damages all layers of soft tissue down to connective tissue and bone. The frostbitten area is hard and wooden and appears lifeless. There is no sensation of pain and the patient cannot voluntarily move the frozen part. With rewarming there are aching pain, burning, and blistering. If there is no pain or other sensation after rewarming, the tissue may be dead and amputation may be indicated.Treatment. Rewarming is best done in an emergency care facility where assessment of the extent of frostbite can be done and appropriate measures taken to rewarm the frostbitten part without further damaging tissue. In the field, it is best to keep the part as warm as possible to prevent further freezing. Blankets and warm clothing are appropriate and, if possible, the frozen area can be placed in contact with any other part of the body that is warm. Rubbing and massaging the area is not recommended because it can only serve to further damage frozen tissue. The victim should not smoke and should avoid caffeine and alcohol because any of these can further restrict blood circulation.
Emergency medical care, if the patient cannot be brought to the hospital and rewarming must be done in the field, includes rapid rewarming in water baths not exceeding 40.6°C (105°F). Hot water can cause further tissue destruction. Tetanus prophylaxis is administered as necessary. If severely frostbitten tissue swells to the point of totally restricting circulation, a fasciotomy may be required to allow adequate blood supply. Vesicles are left intact but frostbitten fingers and toes should be separated with cotton balls and a loose dressing applied. If the patient will be taken outside for transport to a medical facility, rewarming should be started at the hospital.

frost·bite

(frost'bīt), Local tissue destruction resulting from exposure to extreme cold; in mild cases, it results in superficial, reversible freezing followed by erythema and slight pain (frostnip); in severe cases, it can be painless or paresthetic and result in blistering, persistent edema, and gangrene. Frostbite is currently treated by rapid rewarming.

frostbite

(frôst′bīt′, frŏst′-)n. Injury or destruction of skin and underlying tissue, most often that of the nose, ears, fingers, or toes, resulting from prolonged exposure to freezing or subfreezing temperatures.tr.v. frost·bit (-bĭt′), frost·bitten (-bĭt′n), frost·biting, frost·bites To injure or damage by freezing.

frostbite

Tissue damage or destruction induced by temperatures below 0ºC, which is divided into superficial–frostnip and deep forms; in deep frostbite, subcutaneous tissue, muscle, and bone are involved Clinical Numbness, prickling, itching, if severe paresthesia, stiffness, bullae formation, necrosis, gangrene Treatment-immediate Rewarm in water 40-42ºC/104ºF-107.6ºF, never warmer Treatment-post emergent Debride blister, topical aloe vera gel, tetanus prophylaxis, analgesia, NSAIDs, penicillin, hydrotherapy, physical therapy

frost·bite

(frawst'bīt) Local tissue destruction resulting from exposure to extreme or prolonged cold. In mild cases, it results in superficial, reversible freezing followed by erythema and slight pain; in severe cases, it can be painless or paresthetic and result in blistering, persistent edema, and gangrene.

frostbite

Freezing of bodily tissues, especially the tips of the extremities. Expanding ice crystals damage the tissues and the local blood supply is cut off. The result is local tissue death (GANGRENE).

Patient discussion about frostbite

Q. What are the visual distinctions between thermal burns and frostbite? Is it possible to definitively distinguish the two from each other in all cases, or do they present identically in many cases? In other words, are frostbite injuries-for all intents and purposes, actual burns and if they are not, in what ways do they differ?A. Early frostbite and minor burns may resemble one another visually (by whitened, blanched looking skin, and blister formation). However, last stage frostbite and thermal (heat) burns are very different.
In late stage frostbite, the ice crystals in the cells melt and the ruptured cells pour out their contents, then blisters may form. Since the affected area has basically lost circulation, gangrene sets in rather quickly and the tissue turns black and dry.
Deep (full thickness) heat related burns are surrounded by areas of erythema (reddened skin) and skin with less degrees of burning. Also, eschar is obviously charred skin tissue forming a scab like structure, and looks nothing like gangrene. The wound bed in a burn leaks plasma constantly. Blistering is pretty immediate with heat related burns of a sufficient degree.

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Patient discussion about frostbite

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Synonyms for frostbite

noun destruction of tissue by freezing and characterized by tingling, blistering and possibly gangrene

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