Frostbite
Frostbite is tissue damage caused by exposure to low temperatures. Peripheral or poorly protected areas of the body are most often exposed to frostbite. The most common are frostbite of toes, nose, cheeks, ears, frostbite of fingers. It is mistakenly believed that frostbite can occur only at sub-zero temperatures, in the presence of frost. In fact, with high humidity and cold winds, frostbite can occur at zero temperatures, and even slightly higher.
Factors contributing to frostbite
The main mechanism of frostbite is circulatory disorders caused by vasospasm of the microcirculatory bed. Accordingly, all those factors that impair blood circulation contribute to the occurrence of frostbite. Such damaging factors, in addition to cold, include:
- Tight, crushing shoes or clothing;
- Prolonged muscle tension (for example, squeezing the handlebars, etc.);
- Alcohol exposure;
- Diabetes mellitus, atherosclerosis and other diseases in which vascular patency is impaired;
- Blood loss;
- General weakness of the body.
Signs of frostbite
The peculiarity of frostbite and its main danger is that the signs of frostbite appear in full only a day after it happened. Therefore, being in the cold, it is necessary to pay attention to the signs of circulatory disorders, and take urgent measures if they appear.
The first signs of frostbite are tissue whitening. White spots appear on the cheeks, which are most often seen. The ears and nose also turn white, but this can go unnoticed, and whitening of the toes is generally impossible to determine, since they are hidden by the shoes. In case of frostbite of the fingers, you need to focus on loss of sensitivity. Pain during the period of spasm (freezing) does not belong to the characteristic signs of frostbite, it occurs only in the next phase - the phase of paralytic vasodilation. During freezing, pain is possible, but, as a rule, it is very slight.
Tissue damage occurs during a phase of vasodilatation called the reactive period of frostbite. The reaction occurs after the cessation of exposure to cold. Therefore, in full measure, the signs of frostbite, as already mentioned, appear 24 hours after a person is exposed to freezing. Until the end of the reactive period, it is impossible to form an opinion about the depth of frostbite.
Frostbite degrees
Depending on the depth of the lesion, four degrees of tissue frostbite are distinguished. However, in the pre-reactive phase, they do not differ in manifestation, all signs of frostbite relate to the reaction phase:
- First degree of frostbite. The skin is purple-red or blue, subsequently peeling is observed on the frostbite areas. The affected areas are completely restored, only their increased sensitivity to cold remains;
- Second degree of frostbite. The superficial areas of the dermis die, resulting in the formation of blisters, similar to those in burns. Unlike burn blisters, blisters with frostbite contain fluid mixed with blood (hemorrhagic contents). Subsequently, the affected tissues are also completely restored, and, as in the first degree of frostbite, they remain forever hypersensitive to cold;
- Third degree of frostbite. Not only the skin perishes, but also the subcutaneous tissue. At first, the formation of bubbles with hemorrhagic contents is also possible, then areas of dead tissue remain in their place. Healing is quite long, scar tissue forms at the site of the lesion, a cosmetic defect remains forever;
- The fourth, most severe degree of frostbite. There is a death of not only superficial, but sometimes deep tissues - skin, subcutaneous tissue, muscles and even bones. Dead tissues are removed or rejected on their own, while gross defects, tissue deformation, and sometimes, especially with frostbite of the fingers, the loss of a part of the limb are formed. Healing of fourth degree frostbite is very long, it can occur within several months.
First aid for frostbite
First aid for frostbite consists in cessation of exposure to cold as soon as possible. The victim must be taken to a warm place. It should be remembered that the main damage occurs during the reactive period, therefore warming, especially after a long stay in the cold, should be gradual in order to reduce the intensity of the reaction as much as possible.
The best way to warm up a victim during first aid for frostbite is a warm bath, the temperature of which is gradually raised, starting at 20 ° C and bringing it to 40 ° C. Then the damaged area of the body must be washed with soap, to avoid infection, and rubbed with a soft towel. Do not make rough rubbing with snow, woolen cloth, etc., so as not to cause additional damage to the already damaged skin.
If it is not possible to take a warming bath in case of frostbite, first aid consists in rubbing the damaged areas with alcohol, a warm damp cloth, or at least just vigorously massaging them to restore blood circulation. With the onset of frostbite of the fingers, it is necessary to massage them for a rather long time, since this is a peripheral part of the body, and the blood supply here is restored last. An indicator that everything is being done correctly is the restoration of sensitivity, including pain. Therefore, first aid for frostbite includes taking painkillers.
Also, first aid for frostbite consists in taking a warmer inside. It can be hot drinks (tea, milk, cocoa), hot food, a small amount of alcohol is permissible - but only when the victim is already warm. Remember that in the pre-reactive phase, alcohol can make the problem significantly worse.
Frostbite treatment
Treatment of frostbite consists in the fastest possible restoration of blood circulation in damaged tissues, prevention of secondary infection, creation of conditions for better healing of tissues damaged by frostbite and fight against intoxication, which occurs when decay products of dead tissues enter the blood. The tactics of treating frostbite depends on the stage.
Treatment of frostbite of the first and second stages consists in treating superficial injuries with anti-inflammatory ointments and closing them with an aseptic bandage. In the healing phase, physiotherapy is actively used for tissue regeneration.
Treatment of third and fourth degree frostbite requires surgery to remove large areas of necrosis. Surgical treatment of frostbite is carried out when dead tissues are separated from healthy ones - for 8-14 days. Then they use drug therapy aimed at combating inflammation, maintaining normal blood circulation, restoring strength and body functions.
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The information is generalized and provided for informational purposes only. At the first sign of illness, see your doctor. Self-medication is hazardous to health!
