Frostbite - Altmeyers Encyclopedia - Department Dermatology

Synonym(s)

Congelatio; congelation dermatitis

Definition
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Severe cold damage.

Etiopathogenesis
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Climatic exposure to cold, contact with carbon dioxide snow (e.g. fire extinguisher) or liquid nitrogen.

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Clinical features
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Classification in 4 degrees:

(1st degree) Dermatitis congelationis erythematosa: First paleness, then redness.
(2nd degree) Dermatitis congelationis bullosa: damage to the superficial layers of the skin with blistering.
(3rd degree) Dermatitis congelationis escharotica: damage to the deeper skin layers and subcutaneous tissue, necroses.
(4th degree) Gangraena congelationis, cold burn: gangrene, loss of limbs.

External therapy
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Slow heating, keep frozen areas cool at first, as further damage can occur due to the disproportion between the oxygen requirement of the heated tissue and restricted oxygen supply.

Caution!

There is a danger of reheating shock! In case of 3rd degree frostbite, mummification should be sought, therefore dry treatment, e.g. powder treatment, no moist compresses. Surgical measures after demarcation. S.a.u. Burning.

Internal therapy
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Warm and hot drinks, medicinal support for vascular dilatation such as pentoxifylline (e.g. Trental) 800-1200 mg/day p.o. or 1-2 amps slowly (over 5 min.) i.v. or 100-600 mg/day per infusionem (infuse slowly; 100 mg/60 min.). Thrombosis prophylaxis with low molecular weight heparin e.g. Nadroparin (Fraxiparin) 2 times/day 0.1 ml/10 kg KG s.c. If necessary, anti-tetanus prophylaxis.