Frostbite

Diagnosis

Diagnosing frostbite involves assessing signs and symptoms, observing skin appearance, and reviewing recent exposure to cold activities. In some cases, additional imaging tests such as X-rays, bone scans, or MRIs may be requested by your doctor to evaluate the severity of frostbite and detect any potential bone or muscle damage.

Treatment

Frostnip, or mild frostbite, can be addressed at home with initial first-aid measures. In cases of more severe frostbite, following appropriate first aid and evaluation for hypothermia, medical intervention may include processes such as rewarming, medication, wound care, surgery, and diverse therapies, tailored to the severity of the injury.

• Rewarming the skin: If the skin hasn’t been previously rewarmed, your doctor will use a warm-water bath for 15 to 30 minutes. This may result in the skin becoming soft, and you might be advised to gently move the affected area during the rewarming process.
• Protecting the injury: After the skin thaws, your doctor may loosely wrap the area with sterile sheets, towels, or dressings for protection. You may be instructed to elevate the affected area to minimize swelling.
• Oral pain medication: Due to the potential pain associated with rewarming, your doctor is likely to prescribe pain-relieving medication.
• Whirlpool therapy or physical therapy: Soaking in a whirlpool bath can aid healing by promoting cleanliness and natural removal of dead tissue.
• Removal of damaged tissue (debridement): To facilitate proper healing, frostbitten skin should be rid of damaged, dead, or infected tissue.
• Infection-fighting medications: If signs of infection appear on the skin, your doctor may prescribe oral antibiotics.
• Medications: In severe cases, you may receive an intravenous injection of a thrombolytic drug, such as Tissue Plasminogen Activator (TPA), to restore blood flow. Studies suggest that TPA can lower the risk of amputation in severe frostbite cases, but its use is limited due to the potential for serious bleeding, typically administered within 24 hours of exposure.
• Wound care: Various wound care techniques may be employed depending on the extent of the injury.
• Surgery: Individuals with severe frostbite may eventually require surgery or amputation to eliminate dead or decaying tissue.
• Hyperbaric oxygen therapy: Involves breathing pure oxygen in a pressurized room. Some patients have shown improved symptoms with this therapy, healing faster by increasing their blood-oxygen levels.