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Frostnip in winter. Ways to prevent frostbite 

Summary/Definition

Frostbite is a disruption of the physiological compensation base of certain parts of the body caused by exposure to intense cold. It mainly affects the nose, ears, cheeks, chin, fingers and toes. In severe cases, the skin may turn bluish or black, which can lead to the development of necrosis (gangrene) of the skin tissue. Prolonged exposure to necrotic conditions can cause the toes to rot within 5-6 hours, and in the most critical cases, amputation may be required. 

Frostnip, on the other hand, is damage to body tissues caused by exposure to less intense cold, resulting in skin inflammation due to damage to blood vessels and the appearance of ulcers caused by the invasion of bacteria into the damaged areas. 

At temperatures of -15°C and below, the human body has the ability to constrict blood vessels near the surface of the skin in order to maintain body temperature. With prolonged exposure to low temperatures due to cold weather or the environment, the blood vessels remain permanently constricted, resulting in poor blood supply to the extremities and consequent tissue damage. Body tissues begin to freeze at temperatures below 2°C, with ice crystals forming inside the cells and damaging them. On thawing, the cells rupture, exacerbating the damage, and the fluid and proteins released enter the blood vessels, causing swelling and blistering. 

Symptoms 

Depending on the duration of exposure to cold, the most common symptom is numbness. Initially, there is loss of sensitivity to light touch, pain and temperature changes, and paralysis may develop in cases of significant vasoconstriction and vascular damage. With partial tissue damage, there is periodic pain and the prognosis for recovery is good. However, if there is no hemorrhagic blistering or oedema, the prognosis is poor. 

Diagnostics

Diagnosis can be made on the basis of clinical features and the history of exposed parts of the body exposed to cold. There are currently no diagnostic methods available to accurately assess the extent of tissue damage. 

Treatment and course of the disease

In cases of mild frostbite, immediate warming of the frozen areas is of paramount importance. Severe frostbite requires immediate admission to an emergency department. Prior to admission to hospital, the victim should be removed from wet clothing, try not to move the frozen limbs and avoid vigorous rubbing of the frostbitten area, as friction can cause repeated tissue damage. For urgent thawing, the victim can be placed in a bath of warm water at 37°C to 43°C and kept there until the skin becomes soft and reddish. This process can take 30 to 60 minutes and can be accompanied by severe pain, so if there are no contraindications, it is recommended that painkillers are administered. After the skin has been heated, it is necessary to treat it with anticoagulants, anti-inflammatories, antibiotics and other necessary medicines. Necrotic tissue should also be removed. A protein-rich diet and complete cessation of smoking are important components of treatment. 

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