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Frostbite

Frostbite - the body's response to local exposure to low ambient temperatures.



Predisposing factors

Weather conditions

- low air temperature,

- high humidity,

- the wind.

Mechanical impairment of blood circulation

- tight shoes, clothes.

Decreased local tissue resistance

- vascular diseases,

- trophic changes

- relative immobility,

- excessive bending,

Reducing the overall body resistance.

- shock and blood loss,

- tiredness, exhaustion,

- hunger

- infectious diseases,

- hypoxia leading to mental disorders,

- alcohol intoxication.

Frostbite periods

• Pre-reactive period (latent) - the time from the onset of exposure to low temperatures, to the restoration of tissue temperature.

• Reactive period - time since the restoration of blood circulation.

- Early reactive period (up to 7 days)

- Late jet period

Pre-frostbite

The duration of this period and the degree of decrease in tissue temperature are the leading factors of pathological changes in the subsequent reactive period.

Clinical signs

- Complaints of pain, numbness, paresthesia in the form of vague crawling sensations in an injured part of the body, decreased sensitivity.

- The skin is pale, cold.

- Reduced pain and tactile sensitivity.

- The disappearance of the pulse in the peripheral arteries.

- Glaciation is possible.

To judge the depth of damage during this period is not possible.

Treatment principle

- Not forced warming in water (temperature from 20 ° C gradually over an hour, raising it to 37 ° C) with 0.1% potassium permanganate solution.

- Infusion of plasma substitutes heated to 36 * C (reopigluglukin).

- Introduction of anticoagulants of direct and indirect action (heparin, fenilin).

- Introduction of antiplatelet agents (aspirin, trental, chimes).

- Introduction of vasodilating drugs (no-spa, nicotinic acid, theonikol)

- Introduction of vitamins of group B, C, PP (askorutin).

Reactive period

Phase I - inflammation (up to 7 days)

Clinical signs

• Pain, with extensive lesions and plasma loss lead to the development of hypovolemic shock.

• Hyperemia of the skin with a bluish tinge at the site of injury. Edema with deep frostbite significantly exceeds the site of damage, causes secondary impairment of microcirculation and aggravates tissue hypoxia.

• Hyperthermia of the skin.

• Violation of function (movements) by 3-4 days.

• Intoxication (fever, headache, nausea).

Phase II - development of necrosis and its delimitation (from day 7)

Clinical signs

Clinical signs depend on the degree of impairment of regional blood circulation.
This phase clearly shows the depth of the lesion, which is characterized by degrees of gravity.

Degrees of severity:

Grade I - the skin is purple-cyanotic, edema. The process is reversible.

Grade II - on a purple-cyanotic background bubbles containing serous fluid. The bottom of the bubbles is bright red, the bottom palpation is sharply painful.

Grade III - against the background of a purple-cyanotic skin bubbles containing hemorrhagic fluid. The bottom of the bladder is purple, palpation painless.

If, in the absence of blisters, there is a sharp swelling and loss of sensitivity within 48 hours, then the affected person has a 3 degree frostbite.

Stage IV - gangrene, the death of all tissues. External manifestations are similar to frostbite III degree.

Reception of Billroth: if after a day of the reactive period, complete deep anesthesia remains within the same limits and at the same time not blood is released from the injections at the anesthesia sites, but hemolyzed fluid, the areas of anesthesia are considered dead, and their edges are a future demarcation zone.

Frostbite 1-II degree - superficial

Frostbite III grade IV - deep

Local manifestations of frostbite are accompanied by intoxication, the degree of which depends on the size and depth of the lesion. When joining the infection may develop sepsis.



Phase III - scarring and epithelialization

Begins after rejection of necrosis (independently or by surgery).

The outcome of frostbite

P degree - epithelialization.

W degree - scarring.

Grade IV - dry or wet gangrene.

The principle of treatment of frostbite in the reactive period

General treatment

• Antibacterial therapy

• detoxification therapy

• Anti-inflammatory therapy

• Normalization of microcirculation:

infusion of reopoliglyukina, antispasmodics, anticoagulants, antiplatelet agents,

• Vitamin therapy (vitamins C, B1, B6, P, nicotinic acid),

• Symptomatic therapy

• Prevention of tetanus

Local treatment

Frostbite I - II degree treated with conservative methods (wet-drying dressings, dressings with hydrophilic ointments, UHF).

In case of frostbite of the III degree, active surgical tactics are used: transfer of wet necrosis to dry, followed by necrectomy and skin grafting (see treatment of thermal burns).

When frostbite IV degree spend economical amputations:

early on 5 - 7 days,

later - after the formation of a clear demarcation.
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Frostbite

  1. Frostbite
    Frostbite is damage caused by local hypothermia of body tissues. Contribute to the development of frostbite: humid air and wind; alcohol intoxication, which removes the sensitivity of the skin to cold, which increases heat loss due to the expansion of skin vessels; violation of local blood circulation with tight clothes and shoes. There are four degrees of frostbite: I - skin is pale,
  2. Auricle frostbite
    Cause Prolonged exposure to low temperature on the ear. Symptoms Symptoms of mild frostbite of the auricle are redness, the formation of vascular spots. The skin is very sensitive and painfully reacts to touch. The next degree of frostbite of the auricle is average. It is characterized by swelling of the auricle and the formation of blisters. Symptoms III
  3. Frostbite
    Clinical characteristics of frostbite Frostbite - tissue damage that occurs when exposed to negative or low positive temperatures, at which there is a perversion of neurovascular reactions, circulatory disorders, impaired tissue metabolism, the development of edema, secondary tissue necrosis. Degree of frostbite I degree - pallor or cyanosis of the skin, marbling of the vascular
  4. Frostbite
    the nose is quite common, there are four degrees of frostbite: • When after thawing there is swelling and blueness of the skin; • Bubble formation; • Necrosis of the skin and subcutaneous fat; • Necrosis of the skin and cartilage. First aid and treatment: it is necessary to restore blood circulation as soon as possible. To do this, wipe the skin of the nose with alcohol, vodka,
  5. Frostbite
    These are tissue damage as a result of exposure to low temperatures. With the weakening of the body (illness, injury, prolonged exposure to wind and cold) frostbite can occur even at a temperature of +3 ... + 7 ° C. Distal extremities, ears, nose are more susceptible to frostbite. Degree of frostbite I degree - skin lesion in the form of various circulatory disorders. The skin is pale,
  6. Frostbite
    Frostbite - tissue damage when exposed to low temperatures, mainly due to atmospheric air. The basis of pathogenesis is a long vascular spasm with subsequent thrombosis, which leads to trophic and necrotic disorders in the tissues. Contributing adverse physical factors: wind, humid air, duration of exposure to cold, poor body protection by clothing,
  7. Frostbite
    Frostbite is a result of local exposure to cold. The leading factors in the pathogenesis of frostbite are prolonged vascular spasm with impaired microcirculation and thrombus formation, which leads to trophic disorders. During frostbite, there are two periods - hidden and reactive. The latent period is the period of hypothermia. The depth of the damage cannot be determined. You can suspect frostbite
  8. Frostbite
    Frostbite - a condition of the body that occurs in response to exposure to low temperatures and is characterized by varying depth of tissue damage. Adverse environmental factors (wind, low temperatures, insufficient protection of the body by clothes, etc.), as well as the condition of the child’s body (weakness and weak resistance due to illness, insufficient
  9. Question 5. Frostbite
    - tissue damage caused by exposure to low temperatures. The factors contributing to O. include high humidity, high winds, tight shoes and clothing causing circulatory disturbances, alcohol intoxication, a decrease in the general and local body resistance as a result of injury, blood loss, vitamin deficiency, hunger, etc. Peripherals are usually exposed to peripheral areas.
  10. Frostbite of auricles
    Frostbite of the ears develops under the influence of low temperature. After reflex spasm of peripheral skin vessels, their paralytic expansion occurs, congestive hyperemia occurs with the release of liquid blood into the affected tissues, leading to edema, blistering and necrosis. There are 4 degrees of frostbite. I degree - temporary reversible disorder occurs
  11. Frostbite
    Frostbite is a result of local exposure to cold. The leading factor in the pathogenesis is vascular changes. Prolonged vascular spasm with impaired microcirculation and thrombus formation. leading to trophic disorders. During frostbite, there are two periods - hidden and reactive. The latent period is the period of hypothermia. The depth of the damage can not be established.
  12. Question 46. Frostbite
    - tissue damage caused by exposure to low temperatures. The factors contributing to O. include high humidity, high winds, tight shoes and clothing that cause impaired blood circulation, alcohol intoxication, a decrease in the general and local body resistance as a result of injury, blood loss, vitamin deficiency, hunger, etc. Depending on the exposure conditions cold stand out
  13. PERIODS AND DEGREE OF FROZEN
    In the clinical course of frostbite, two periods are clearly distinguished: before warming up - pre-reactive (or latent) and after warming - reactive. Direct cell damage occurs during the reactive period. Consequently, only after an increase in the interstitial temperature and the completion of pathophysiological changes can one judge the degree of frostbite. The process of tissue death sometimes takes up to 5 -
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  15. COMPLICATIONS OF FROSTBACK
    Distinguish: A. Early complications: 1) general - sepsis; 2) local - a) suppuration of bubbles; b) acute lymphangitis and lymphadenitis; c) abscesses and phlegmon; d) acute purulent arthritis. B. Late complications: 1) osteomyelitis; 2) trophic ulcers; B. The effects of frostbite; 1) obliterating vascular diseases of the extremities; 2) neuritis; 3) skin
  16. Frostbite
    Lesions due to low temperatures can occur not only in northern areas and not only in winter, but also at other times of the year and in southern latitudes (for example, when exposed to dry ice). The leading role in the development of frostbite plays a long spasm of arterioles due to the effects of low temperatures, then thrombosis develops in them, which exacerbates the severity of the disorder.
  17. The concept of frostbite, their classification and first aid
    Frostbite - damage to body tissues due to exposure to low temperatures. Frostbite is promoted by moisture, increased wind, exhaustion, vitamin deficiency, tissue compression, anemia. In the development of frostbite allocate pre-reactive and reactive periods. In the prereactive period (under the influence of cold), there is a violation of microcirculation, accompanied by vasospasm. Appears sharp
  18. Lecture. Cold injury, help with frostbite and hypothermia, 2011
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  19. Therapeutic tactics for frostbite
    Cold lesions (frostbite) are tissue damage caused by exposure to low temperatures. In depth and severity also distinguish 4 degrees. I degree - characterized by edema, hyperemia of the skin with a bluish tinge. Sensation of coldness, chills. Grade II - skin color is purple-bluish, tissue swelling, the appearance of bubbles with serous or serous-hemorrhagic contents. Appear
  20. First aid for frostbite
    Frostbite is tissue damage due to exposure to low temperature. Frostbite can occur at not very low temperatures, but in the presence of wind, high humidity, wet clothes or shoes, intoxication, blood loss. When frostbite at first there is a feeling of cold, the affected place becomes white, then numb. First aid in the cold: a frostbitten nose or
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