Freezing injury

Freezing injury is a damage of fabrics as a result of influence of low temperature. The peripheral or badly protected from cold body parts most often are exposed to freezing injury. Most often freezing injury of toes, a nose, cheeks, ears, freezing injury of fingers of hands meets. Mistakenly it is considered that freezing injury can come only at subzero temperature, in the presence of a frost. Actually high humidity and cold wind freezing injury can come also at a zero temperature, and is even slightly higher.

The factors promoting freezing injury

The main mechanism of freezing injury is the blood circulation disturbance caused by a vasospasm of a microcirculator bed. Respectively, all those factors which worsen blood circulation promote developing of freezing injury. In addition to cold, treat such disturbing factors:

• The close, squeezing footwear or clothes;
• Long muscle tension (for example, tightening by a wheel hand, etc.);
• Alcohol influence;
• Diabetes mellitus, atherosclerosis and other diseases at which passability of vessels is broken;
• Blood loss;
• General weakening of an organism.

Symptoms of freezing injury

Feature of freezing injury and its main danger that symptoms of freezing injury are shown fully only days later after it occurred. Therefore, being on cold, it is necessary to pay attention to blood circulation disturbance signs, and at their emergence to take urgent measures.

The first symptoms of freezing injury is albication of fabrics. On cheeks there are white spots which are noticed most often. Also ears and a nose grow white, but it can remain unnoticed, and albication of fingers standing in general cannot be defined as they are hidden by footwear. In case of a frostbite of fingers it is necessary to be guided by an anesthesia. Pain in the period of a spasm (freezing) does not treat characteristic symptoms of freezing injury, it arises only in the following phase – a phase of paralytic vasodilatation. During freezing pain is possible, but, as a rule, they are very insignificant.

Damage of fabrics happens in the phase of vasodilatation called by the reactive period of freezing injury. Reaction comes after the termination of impact of cold. Therefore fully symptoms of freezing injury as it was already mentioned, are shown 24 hours later after the person underwent freezing. Before the end of the reactive period it is impossible to size up freezing injury depth.

Freezing injury degrees

Depending on defeat depth, allocate four degrees of freezing injury of fabrics. However in a doreaktivny phase they have no distinctions in manifestation, all symptoms of freezing injury concern a reaction phase:

• First degree of freezing injury. Skin of purple-red or blue color, afterwards on the freezed sites is observed a peeling. Affected areas are recovered completely, there is only their hypersensitivity by cold;
• Second degree of freezing injury. Superficial sites of a derma perish therefore the bubbles similar to those at burns are formed. Unlike burn bubbles, bubbles at freezing injury contain liquid with blood impurity (hemorrhagic contents). In the subsequent the struck fabrics are also recovered completely and as at the first degree of freezing injury, forever keep hypersensitivity by cold;
• Third degree of freezing injury. Not only skin, but also hypodermic cellulose perishes. In the beginning formation of bubbles with hemorrhagic contents is also possible, then on their place there are sites of devitalized fabrics. Healing is quite long, on site defeats cicatricial fabric is formed, forever there is a cosmetic defect;
• Fourth, heaviest degree of freezing injury. There is a death not only superficial, but sometimes and deep fabrics – skin, hypodermic cellulose, muscles and even bones. Devitalized fabrics are removed or torn away independently, at the same time rough defects, deformation of fabrics, and sometimes are formed, especially at freezing injury of fingers, loss of a part of an extremity. Healing of freezing injuries of the fourth degree very long, can happen within several months.

First aid at freezing injury

First aid at freezing injury consists in as much as possible bystry termination of impact of cold. The victim needs to be taken away to the warm place. At the same time it is necessary to remember that the main damages happen during the reactive period therefore warming, especially after long stay on cold, has to be gradual whenever possible to reduce intensity of reaction.

In the best way to warm the victim during first-aid treatment at freezing injury, the heat bath which temperature is increased gradually is, since 20 °C and bringing to 40 °C. Then the damaged body part needs to be washed up with soap, in order to avoid infection and to pound a soft towel. It is impossible to make rough grindings by snow, woolen fabric, etc. not to put additional damages to already affected skin.

If there is no opportunity to take the warming bath in case of freezing injury, first aid consists in grinding of the damaged sites alcohol, warm wet fabric, or at least their just vigorous massaging for blood circulation recovery. At the come freezing injury of fingers it is necessary to mass them it is quite long as it is a peripheral body part, and blood supply is recovered in the last turn here. An indicator that everything becomes correctly is sensitivity recovery including painful. Therefore first aid at freezing injury includes reception of anesthetics.

Also first aid at freezing injury consists in reception warming inside. It can be hot drinks (tea, milk, cocoa), hot food, a small amount of alcohol – is admissible but only when the victim already is in heat. Remember that in a doreaktivny phase alcohol can aggravate a problem considerably.

Treatment of freezing injury

Treatment of freezing injury consists in as much as possible bystry recovery of blood circulation in the damaged fabrics, prevention of accession of consecutive infection, creation of conditions for the best healing of the fabrics damaged by freezing injury and fight against intoxication which comes at intake of decomposition products of the died fabrics in blood. Tactics of treatment of freezing injury depends on a stage.

Treatment of freezing injury of the first and second stages consists in processing of superficial damages by antiinflammatory ointments and closing with their aseptic bandage. In a healing stage actively use physical therapy for an angenesis.

Treatment of freezing injury of the third and fourth degree demands surgical intervention for removal of extensive sites of a necrosis. Surgical treatment of freezing injury is carried out when the died fabrics are delimited from healthy – for 8-14 day. Then apply the medicamentous therapy directed to fight against an inflammation, maintenance of normal blood circulation, recovery of forces and functions of an organism.