Frostbite - Causes, symptoms and treatment. MF.

Frostbite is a specific skin lesion caused by low temperatures, strong wind and high humidity, with reduced reactivity of the body. Most often, such injuries are susceptible to limbs and protruding parts of the body: ears, nose, area of ​​cheekbones. Predisposing to the development of frostbite close shoes and restriction of mobility, resulting in a violation of microcirculation and innervation of the skin. Violation of blood supply can occur not only in severe frost. The oxygen necessary for tissues for normal vital activity ceases to flow to them already at 8 degrees above zero. Therefore, under additional conditions, such as tight and damp clothes, constant holding in the hands of an object, prolonged immobility and weakening of the body by stresses, inadequate nutrition, avitaminosis, spasm of small vessels, blood flow disturbances and a deficiency of tissue enzymes occur. Thus, tissue saturation with oxygen decreases, which leads to tissue necrosis.

Symptoms of frostbite

To provide correct and timely assistance to the victim with frostbite, such skin lesions are divided by severity. The easiest - 1 degree, is characterized by sensations of numbness, tingling, burning. The affected skin is pale, after warming it is edematous and reddened with a purplish-red hue. Such damage to tissues is usually restored after 5-7 days, passing the peeling stage.

Symptoms of frostbite of 1 degree

At 2 degrees of frostbite there are bubbles with transparent contents, after warming of the skin there are intense itching and sharp soreness of the affected skin. It may take 2 weeks to restore the skin.

Symptoms of frostbite of 2nd degree

3 degree is characterized by the defeat of all layers of the skin by necrosis. Bubbles are filled with bloody contents. Healing takes a long time, more than a month, with the formation of scars.

Symptoms of frostbite of the 3rd degree

With 4 degrees of necrosis all layers of soft tissues are exposed. The defeat of the skin is manifested by a pronounced, persistent edema and loss of sensitivity.

Symptoms of frostbite of the 4th degree

Symptoms of subcooling

It should be noted that under the influence of low ambient temperatures, it is possible not only to localize the skin in the form of frostbite. Often there is a general supercooling of the body, which is manifested by a decrease in the overall body temperature below 34 degrees, a chill, a decrease in heart rate, respiratory rate, blood pressure, a general disorder, and sometimes even a violation of consciousness. Skin covers of the whole body are pale, cyanotic, with "goose-skin" elements.

This systemic damage to the body can also occur as a result of increased absorption of necrotic tissues from the focus of frostbite. In this regard, when the first symptoms of a violation of the general condition of the body should consult a specialist. Since when the body warms up, "oxygen deficiency of tissues" will manifest, then hypoxia will increase, and the general state of progress will progress. In the hospital, the level of acid-base balance in the blood will be estimated to determine the severity of the victim.

First aid for frostbite

When the first clinical signs of frostbite occur, it is necessary to warm not only the damaged limb in a warm room, but also the injured person as soon as possible.

At the first degree of frostbite, the affected skin should be warmed with warm hands, with a light massage, and a sterile cotton-gauze bandage applied.

It is recommended to apply moisturizing creams on the flaking skin such as: "Koldkrem", "Trikzera", "Emoljant extremum", "Kzemoz" several times a day and after contact with water.

Safe folk remedies used for frostbite of an easy degree are decoctions of herbs: oak bark, chamomile as a compress or a common bath. For the warming compress use gauze, folded in 5-6 layers, moistened with a decoction of the above-mentioned herbs at room temperature, superimposed on the frost-bitten area of ​​the skin, then a polyethylene film, on top of a thick layer of gray cotton wool and pribintovyvayut for 6-8 hours. To create optimal sealing conditions, each subsequent layer should be enlarged in area. This procedure leads to an expansion of the vessels and, accordingly, warming the skin.

Self-injured person should give hot drink, hot food. It is possible to take drugs from the group of non-steroidal anti-inflammatory drugs( analgin), from the group of salicylates( aspirin), from the group of antispasmodics( no-shpa, papaverine).

With a mild degree of total body freezing, manifested by body temperature of 32-34 ° C, pale or moderately cyanotic skin, goosebumps, chills, difficulty speaking, slowing heart rate to 60-66 beats per minute and I-degree frostbite, it is possible to warm uporganism in the following way. The victim is placed in a warm bath with an initial water temperature of 24 ° C, which is gradually increased to normal body temperature.

In case of deeper skin damage, II-IV degree, it is not recommended to rub the damaged skin, frostbitten limb should be fixed with improvised means, bandaged with sterile material, warmed and called for an ambulance.

When cooling the body, accompanied by a body temperature below 32, rare and shallow breathing, vomiting, convulsions of the affected person is also recommended to be delivered to the hospital as soon as possible.

Treatment with frostbite

In case of frostbite of the 2nd degree, the blisters of the blisters are opened and the aseptics removed according to all rules. The skin around the blisters is treated with alcohol solutions of boric or salicylic acid. Apply bandages with antibacterial ointments, preparations for stimulation of regeneration processes: Dermazin, Levomikol. After 5-10 days, physiotherapy procedures are appointed: electrolight baths, ultraviolet irradiation starting with suberythmic doses, UHF therapy, darsonvalization method. For the prevention of secondary infection intramuscularly prescribed antibacterial agents( penicillin)

With frostbite of the third degree after removing the blisters and determining the boundaries of the necrosis of the skin, bandages with hypertonic NaCl solution are used. During the first week of treatment, dead tissue is removed. To improve wound healing, physiotherapeutic methods of treatment are also used. Sometimes, to limit limb mobility, a plaster bandage is applied.

With frostbite of the IV degree, excision of the dead tissue, amputation of the extremities is performed.

In the treatment of chronic dermatitis caused by prolonged exposure to the skin of low temperatures, the restorative and vitamin teas and remedies improving the peripheral circulation are used. A patient with frostbites in a diet needs to strengthen protein-vitamin ingredients. Of the physiotherapy procedures, ultraviolet irradiation in suberitemic doses is most important.

The outcome and prognosis of frostbite on the direct depends on the degree of tissue damage. In case of mild frostbite, after repairing the damaged skin it is necessary to treat it carefully. Repeated frostbite, previously affected skin, can occur much faster. The result of severe frostbite can be not only a loss of limb, but a lethal outcome.

As mentioned above, there are a lot of factors that increase the possibility of frostbite in the cold season, so it is very important to approach the issue of preparing an exit to the street in such a difficult period for the body.

Doctor's consultation on frostbite:

1. Is it true that excessive sweating of the feet is the cause of their frostbite?
Perspiration of the feet leads to an increase in the humidity of clothes and shoes that come into contact with the skin and thereby reduce their thermal insulation properties.

2. Why are older people and children most affected by frostbite?
Blood supply to the limbs directly depends on the amount of blood flowing to the tissues through the vessels. Elderly people are not only characterized by obliterating diseases of the limbs, but also various systemic diseases of blood vessels and capillaries. All this is a fundamental predisposing factor for getting a skin lesion in the cold season. By the way, people who smoke, precisely because of the constant spasm of peripheral vessels, are also more likely to have frostbite of the extremities. Children's body has not yet fully formed the mechanism of thermoregulation, so any subcooling is not ready to give a corresponding response.

3. What skin diseases increase the risk of frostbite?
All diseases resulting in impaired blood supply to tissues predispose to the development of frostbite. As an example, there are various systemic diseases of connective tissue, cicatricial atrophy.

4. Why is a weakened organism more susceptible to frostbite?
In an organism that has recently undergone physical overstrain, mental trauma, colds and various other injuries, all metabolic processes are reduced, the blood supply of tissues is limited and accordingly less produced, much needed in the cold season, heat.

5. Why do people in alcohol intoxication often get skin lesions from the cold?
This is due to the fact that because of the expansion of peripheral blood vessels with alcohol, the body loses more heat. Such a person does not feel the beginning symptoms of skin damage due to a lower threshold of sensitivity under the influence of the alcoholic factor. Often, an aggravating factor is prolonged immobility and movement of limbs, as a result of which blood supply to underlying tissues and their ischemia( bleeding) is impaired. In such tissues there is a massive cell death, resulting in the formation of necrosis.

6. Why can not frostbite freeze the skin with snow?
Vessels in such skin are very fragile and can easily be damaged by snow rubbing, which will exacerbate the picture of the lesion. Mechanical injuries caused by snow, scratches - this is an additional factor for infection of the affected skin.

7. Is it recommended to grind frostbitten skin with alcohol solutions, oils, fats?
Such an approach is not permissible with deep forms of defeat: II-IV degree. It is often not easy for an inexperienced eye to differentiate the severity of frostbite.

8. Why it is impossible to warm a frostbitten limb at an open fire, battery, heater? The sensitivity of such affected tissues is reduced. A case of additional skin damage is possible, but already a form of thermal burn.

9. How to dress during frost to avoid frostbite?
It is necessary to dress in such a way that the layers of clothing do not fit snugly against each other and leave interlayers of air between them, which perfectly hold the heat. Outer clothing must be waterproof and non-inflatable. Shoes should also not be cramped and dry. With excessive sweating of the feet, it is recommended to use warm insoles and woolen socks on the bare leg, as they absorb excess moisture and leave the feet dry.

10. Why is it not recommended to wear finger rings during frosts?
Firstly, the rings on the fingers often disrupt the normal blood flow, which is very important in the conditions of frost. Secondly, the metal cools faster in the cold to low temperatures, and thus is a potentially cooling factor.

11. What should I do when the skin, mucous membranes to freezing iron objects "freezes"?
It is necessary to pour warm, but not hot water adherent place, the metal will warm up and rupture its "contact" with the skin. Such wounds are usually not deep. It is necessary to stop bleeding and disinfect such damage with hydrogen peroxide. Then you can apply "Olazol", "Dermazin", etc., successfully used to treat wet surfaces. To the doctor with such kind of damages it is still necessary to apply.

Doctor dermatologist Kuklin TP