Related articles: Freezing
Definition
Freezing is a tissue damage caused by prolonged exposure to extreme cold. The initial phases of the phenomenon are superficial and do not cause permanent injury. Severe freezing, however, requires medical attention, as it causes destruction of the skin tissues and underlying blood vessels. If blood flow cannot be restored, it deprives oxygen cells, eventually leading to tissue death (gangrene).
Freezing is not a common problem, but some people who practice winter sports at high altitudes, or who work in extreme weather conditions for a long time (sailors and rescuers) are more susceptible. In these contexts, the same factors that can lead to freezing (cold temperatures, inadequate clothing, wet clothes, freezing wind, etc.) can contribute to systemic hypothermia (or frostbite), which produces effects on the entire organism.
Most common symptoms and signs *
- bubbles
- Swollen arms
- Cyanosis
- Coma
- Bruising
- Edema
- Erythema
- eschar
- blisters
- Tingling in the legs
- Hyperhidrosis
- Hypoxia
- Hypothermia
- Lethargy
- Pallor
- Paresthesia
- itch
- blisters
Further indications
The most distal parts of the limbs (fingers and toes) and the exposed skin (such as the nose and ear lobes) are the regions of the body most susceptible to freezing.
Symptoms of freezing onset include numbness, tingling, itching, burning and pain in the affected area. The skin becomes cold and pale due to local vasoconstriction. If exposure to cold continues, freezing extends to the epidermis and dermis; the skin becomes blue-white, devoid of sensitivity and begins to harden to the touch.
The same affected area becomes bright red, swollen, itchy and painful when heated. After 1-2 days, blisters or blisters may appear; if these skin lesions contain clear serous material, superficial damage may be suspected, while a blood content indicates the involvement of the deeper layers. The medical intervention in these early stages is necessary to ensure that no permanent consequences occur: complete recovery is possible with the rapid transfer of the patient to a warm place with first aid measures.
Deep tissue freezing, on the other hand, causes damage to muscles, tendons, blood vessels and nerves. In fact, an inflammatory process is established which temporarily and permanently compromises the functionality of the area involved (the frozen tissues begin to necrotize). During heating, the bubbles fill with blood and turn into thick purple-black crusts, while damage to nerve endings can cause permanent loss of sensitivity.
The worst consequences occur in tissues that freeze, thaw and re-freeze. Badly damaged tissue can develop gangrene and undergo self-amputation.
The treatment consists of heating with hot water baths that are tolerable to the touch (from 40 to 42 ° C) and the use of local drugs (analgesics). It is important to remember that rubbing in an attempt to heat the affected area can cause further injury: friction destroys the already damaged skin, as well as increasing the risk of infection.
Surgical debridement and amputation to remove necrotic tissue are usually delayed procedures, with exceptions for signs of infection or gas gangrene. A number of long-term neuropathic symptoms can follow frostbite: hypersensitivity to cold, hyperhidrosis, persistent pain, defective nail growth and paresthesia.
