Frostbite

As the winter season begins, A Step Ahead Foot & Ankle Center wants to remind you of the very real potential for frostbite injuries. The feet are among the most commonly affected body parts for these injuries. Skiers, ice-skaters, joggers, mountain climbers and outdoor enthusiasts are all prone to frostbite, as well as those that must work outdoors to make a living. In addition, anyone with diabetes or peripheral vascular disease is at particularly high risk.

The danger of frostbite must be considered very strongly whenever there is exposure to extreme cold. It is caused by actual freezing of the soft tissues. Frostbite can be classified into four stages based on the degree of injury. First-degree frostbite produces white patches on the skin’s surface. There is often numbness and swelling, but no tissue loss. Second-degree frostbite is represented by pale skin that does not blanch (turn white) when pressure is applied. Clear colored blisters, swelling and redness may develop. If any numbness occurs that does not clear in a few hours, then deeper tissue damage is likely. In cases of third-degree frostbite, the blisters are larger, deeper and purplish with blood. The swelling and redness can be dramatic, and there is a high probability of deep tissue injury with some permanent loss. Fourth-degree frostbite involves the deep soft tissues including bone and can result in mummification of the tissues and require amputation.

Patients who have frostbite injuries that are greater than first degree should be observed in a hospital. The accepted therapy for frostbite is re-warming, but care must be taken not to burn the area with excessive heat as tissues are often numb. Rubbing or massaging of frostbitten areas is strongly discouraged because it can lead to further damage. Once the body part has been re-warmed and blood flow returns, the injured area may appear mottled, blue or purple. There may also be swelling, resulting in large blisters or gangrenous areas several days after treatment. Tetanus vaccination, antibiotics and surgery may be required.

Ultimately, the best way to treat any cold-related injury is through prevention. This requires awareness of not only the actual temperature, but also the wind chill factor. Remember to wear clothing which allows sweat to evaporate and protects against the cold. Wool and wicking synthetics, such as polyester, are good materials to wear. Cotton is not recommended as it will actually retain moisture and facilitate heat loss due to convection. Keep shoe gear dry. Avoid smoking and alcohol consumption when venturing out into extreme temperatures. Nicotine causes vasoconstriction, which decreases blood flow to the feet, and alcohol hinders the body’s ability to sense temperature accurately and can cause heat loss. Go inside when feeling too cold. Do not ignore your body’s warning signs.

If you suspect that you have a cold-related injury such as frostbite, seek emergency medical care as soon as possible. Get out of the cold and into a warm environment as quickly as possible. Keep your feet dry and warm. Do not expose the flesh to extremely warm or hot temperatures (such as a fire or a portable heater). A gradual and steady warming procedure should be followed.

For all your foot-related healthcare needs, please contact our office for an appointment.