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Frostbite 

Frostbite
Chapter:
Frostbite
Author(s):

Sujatha Tadiparth

and Kayvan Shokrollahi

DOI:
10.1093/med/9780199699537.003.0042
Page of

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date: 29 March 2020

Frostbite is the damage sustained by tissues when exposed to temperatures below their freezing point (<0°C). Extremities such as fingers, toes, nose and ears are most commonly affected. A number of extrinsic and intrinsic factors predispose to frostbite. The severity of frostbite can be classified into four degrees. Tissue injury occurs firstly, by direct cell damage and death from the formation of intracellular ice crystals and secondly, by vascular insufficiency and tissue ischaemia which result from vasoconstriction, endothelial injury and thromboembolism. Treatment is focused on gentle rewarming in a warm circulating bath (40–41°C). Tissues should be allowed to demarcate with rewarming and then surgical debridement or amputation performed if necrotic tissue is present. Tissue plasminogen activator can lead to rapid clearance of vascular thromboses, restore arterial perfusion and improve tissue salvage. Long-term sequelae can result including, cold hypersensitivity, sensory deficits, chronic pain, heterotropic calcification, and pigmentary changes.

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