Even today, frostbite although lieichteren degree occurs very often. Here, the local cold damage plays the greatest role. The feet are most affected by it. Then follow the fingers, ears, chin, cheeks and zygomatic region, but also the tip of the nose, which is particularly vulnerable due to its moist breathing air. We know acute and chronic cold damage. Both differ not only in their cause of origin, but also in their clinical picture.
Forms and stages of frostbite and hypothermia.
The first aid for hypothermia is heat preservation, i.e., cover or wrap patients with a wool blanket. Never place a rescue blanket directly on the skin; it will be useless because of its lack of insulating effect. Click to enlarge. While chronic cold injury is caused by repeated exposure to cold of a lighter degree, acute frostbite is caused by a single extremely intense exposure to cold. Similar to burns, we can divide acute frostbite into three stages. The first stage is redness, which occurs, for example, when rewarming fingers that have become cold and is accompanied by a slight itching sensation. Every one of us knows this discomfort when fingers feel thick after long skating or sledding and the skin is reddened with inflammation. This condition disappears immediately if the skin is warmed up in time. However, if the exposure to cold is not interrupted, frostbite reaches the second stage. Rough blue-red blisters and. Water accumulation in the crevices of the surrounding tissue. The hallmark of third-degree frostbite is necrosis, the complete death of an organ or part of an organ or tissue in the midst of a living environment. The bubbles formed take on a black coloration, the base of the bubble becomes gangrenous, tissue defects appear; In such cases, even thawing can no longer help; the frostbitten tissue repels, so that the loss of fingers, toes, and even arms and legs may occur.
Treatment
These severe forms of frostbite, as common as they were during World War 2, for example, are fortunately very rare today. In contrast, first-degree frostbite can develop much more quickly and can also occur during a normal Central European winter. Therefore, even the non-expert should know something about its treatment. The often recommended rubbing of the cold-damaged areas with snow is to be used only conditionally, since it can lead to the smallest injuries of the skin. However, superficial skin carvings allow the penetration of bacteria, which can cause inflammation in the cold-damaged, less perfused tissue areas. Thawing can be carried out without further ado in warmed rooms, supported by careful massaging with soft pre-warmed cloths. As a follow-up treatment, alternating baths and rehabilitation sports are recommended for vascular training.
Chronic frostbite, cold damage, and frostbite.
However, we are most often dealing with chronic cold injury or frost damage in our geographic latitudes. Two main factors are responsible for this; first, of course, the exposure to cold and, second, the disposition to circulatory instability; namely, the lack of adaptability of the circulatory system present in such cases is the basis for the chronic effects of the cold stimulus. Undoubtedly, however, the relatively widespread lack of exercise and clothing also play a major role. The fact that, for example, women suffer much more frequently than men, and here again mainly girls in or after sexual maturity, from chronic cold damage is mostly due to thin pantyhose, short skirts, the silk stocking clothing and silk undergarments, possibly also to a certain hormonal disposition. Most often, there is damage to the skin of the lower leg between the upper edge of the shoe and the hem of the skirt. Another frost damage, which is not caused by insufficient, but mainly by constricting clothing that inhibits blood circulation, is the well-known frostbite. Tight, pointed footwear, which constricts the foot and whose leather sits firmly on the skin, favors its development. It is also not uncommon to see frostbite on the inside of the knees in women who wear half-length underpants or even thongs.Wearing half-high women’s boots also creates a red stripe on the skin at the upper edge of the boots in cold weather. Unlined, tight gloves can also lead to the formation of circumscribed frost knots. Although frostbite is more prominent during the cold season and recedes during the warmer months, it causes the most discomfort during the transition months from warm to cold weather. From this we can see that it is not so much the exposure to cold alone that is responsible for the development of frost damage and hypothermia, but rather the transition from one temperature level to another. In the transitional periods, frostbite is particularly unpleasant, whereas in the height of winter or summer it hardly causes any discomfort. These cushion-like swellings of blue-red color, which occur mainly on the toes, edges of the feet, heels and backs of the hands, can also form blisters and begin to fester if the frost damage is more severe. Most annoying, however, is their itching, which usually occurs in the evening when the room or bed is warm. Another form of hypothermia or frostbite that exclusively affects women, especially those with more developed fat pads, is the blue discoloration of the lower legs. These skin changes are strictly symmetrical and surround the lower legs in a cuff-like manner. As already mentioned, the skin follicles are enlarged and intensely discolored. The skin temperature is reduced, so that the legs almost always feel cold. In the cold season, this condition regularly worsens and is then less disturbing because of the slight itching or the minor pain, but rather from a cosmetic point of view. In addition, bacteria can settle on this damaged skin and cause deeper diseases. In addition to the hands and feet, this cold damage often affects the nose, cheeks and ears. They can be recognized by the blotchy blue-red discolorations that appear mainly in young people with a tendency to sweaty feet and sweaty hands. On the basis of these frost spots occasionally real frost nodules develop, which we can find especially often on the auricular parts. They are usually noticeable by severe itching and considerable pain. This disease process, which repeats almost annually, leads over time to painful nodules located at the edge of the ear, which occasionally break open and then leave whitish larger scars.
Prevention
As already briefly indicated, one can prevent most frostbite and frost damage. Circulatory training, in particular, plays an essential role in this regard. Brush massages, frequent alternating showers all over the body, stroking and kneading massage or underwater jet massage, carbonic acid gas baths, treading water and also swimming are suitable methods to stimulate the circulation, train the blood vessels and thus make the tissues more resistant. It is also essential to wear clothing that provides adequate protection against the cold and does not inhibit circulation, i.e. is too tight. Furthermore, one should counteract possible perspiration and avoid moisture penetration into the skin. Shoes and gloves should be comfortable and lined. It is also important to know that metal objects, for example, can cause frostbite very quickly because of their good conductivity. Already formed frostbite is best treated with one of the frost ointments for sale. Bath additives; brushes and sprinkling powders of various compositions are also recommended. Among them, ammonium bituminosulfonate (e.g., ichthyol), camphor, iodine, Peru balsam, alum, and tannin have proved effective since ancient times. But better and more effective than all methods of treatment are and remain, of course, the preventive measures, with the help of which one can avoid the greater part of all hypothermia and frostbite.
