Skip to main content

Frostbite

  • Chapter
  • First Online:

Abstract

Frostbite is a severe localized cold-induced injury caused by the freezing of soft tissue, secondary to exposure to temperatures below the freezing point of intact skin. It typically affects the peripheral upper and lower extremities but can also include areas of the face, such as the nose, cheeks, and ears. The sequelae of injury can be mild to severe, with treatment management ranging from watchful waiting to local wound care to major limb amputation. Intriguingly, it is a disease process that is unique in its vague initial presentation which can take a period of several months to determine the final demarcation of tissue damage. Given its nature of delayed presentation, a treatment guideline for early frostbite injuries remains elusive with no clear consensus of definitive intervention. As such, timely diagnosis, initial management, and patient education are vital in the prevention and provision of optimal treatment and tissue salvage in frostbite injuries [1].

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   99.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Nygaard RM, Lacey AM, Lemere A, et al. Time matters in severe Frostbite: assessment of limb/digit salvage on the individual patient level. J Burn Care Res. 2017;38(1):53–9.

    Article  PubMed  Google Scholar 

  2. Biem J, Koehncke N, Classen D, Dosman J. Out of the cold: management of hypothermia and frostbite. Can Med Assoc J. 2003;168(3):305–11.

    Google Scholar 

  3. Danielsson U. Windchill and the risk of tissue freezing. J Appl Physiol. 1996;81(6):2666–73.

    Article  CAS  PubMed  Google Scholar 

  4. Moore GW, Semple JL. Freezing and frostbite on Mount Everest: new insights into wind chill and freezing times at extreme altitude. High Alt Med Biol. 2011;12(3):271–5.

    Article  CAS  PubMed  Google Scholar 

  5. Hashmi MA, Rashid M, Haleem A, Bokhari SA, Hussain T. Frostbite: epidemiology at high altitude in the Karakoram mountains. Ann R Coll Surg Engl. 1998;80(2):91–5.

    CAS  PubMed  PubMed Central  Google Scholar 

  6. Friedman NB, Kritzler RA. The pathology of high-altitude Frostbite. Am J Pathol. 1947;23(2):173–87.

    CAS  PubMed  PubMed Central  Google Scholar 

  7. Durand J, Varene P, Jacquemin C. Cardiac output and regional blood flows in altitude residents. In: Brendel W, Zink RA, editors. High altitude physiology and medicine. New York, NY: Springer; 1982. p. 129–41.

    Chapter  Google Scholar 

  8. Hu J, Li H, Geng X, et al. Pathophysiologic determination of Frostbite under high altitude environment simulation in Sprague-Dawley rats. Wilderness Environ Med. 2016;27(3):355–63.

    Article  PubMed  Google Scholar 

  9. Molnar GW, Hughes AL, Wilson O, Goldman RF. Effect of skin wetting on finger cooling and freezing. J Appl Physiol. 1973;35(2):205–7.

    Article  CAS  PubMed  Google Scholar 

  10. Castellani JW, Young AJ, Ducharme MB, Giesbrecht GG, Glickman E, Sallis RE. American College of Sports Medicine position stand: prevention of cold injuries during exercise. Med Sci Sports Exerc. 2006;38(11):2012–29.

    PubMed  Google Scholar 

  11. Giesbrecht GG, Wilkerson JA. Hypothermia, Frostbite and other cold injuries: prevention, survival, rescue, and treatment. Seattle, WA: Mountaineers Books; 2006.

    Google Scholar 

  12. Murphy JV, Banwell PE, Roberts AH, McGrouther DA. Frostbite: pathogenesis and treatment. J Trauma. 2000;48(1):171–8.

    Article  CAS  PubMed  Google Scholar 

  13. Imray C, Grieve A, Dhillon S. Cold damage to the extremities: frostbite and non-freezing cold injuries. Postgrad Med J. 2009;85(1007):481–8.

    Article  CAS  PubMed  Google Scholar 

  14. Wrenn K. Foot problems in homeless persons. Ann Intern Med. 1990;113(8):567–9.

    Article  CAS  PubMed  Google Scholar 

  15. Reamy BV. Frostbite: review and current concepts. J Am Board Fam Pract. 1998;11(1):34–40.

    Article  CAS  PubMed  Google Scholar 

  16. Fudge J. Exercise in the cold: preventing and managing hypothermia and Frostbite injury. Sports Health. 2016;8(2):133–9.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Boles R, Gawaziuk JP, Cristall N, Logsetty S. Pediatric frostbite: a 10-year single center retrospective study. Burns. 2018;44(7):1844–50. https://doi.org/10.1016/j.burns.2018.04.002. Epub 2018 Jul 30.

    Article  PubMed  Google Scholar 

  18. Valnicek SM, Chasmar LR, Clapson JB. Frostbite in the prairies: a 12-year review. Plast Reconstr Surg. 1993;92(4):633–41.

    Article  CAS  PubMed  Google Scholar 

  19. Harirchi I, Arvin A, Vash JH, Zafarmand V. Frostbite: incidence and predisposing factors in mountaineers. Br J Sports Med. 2005;39(12):898–901; discussion 901.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Lehmuskallio E, Lindholm H, Koskenvuo K, Sarna S, Friberg O, Viljanen A. Frostbite of the face and ears: epidemiological study of risk factors in Finnish conscripts. BMJ. 1995;311(7021):1661–3.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Ervasti O, Juopperi K, Kettunen P, et al. The occurrence of frostbite and its risk factors in young men. Int J Circumpolar Health. 2004;63(1):71–80.

    Article  PubMed  Google Scholar 

  22. Lehmuskallio E, Anttonen H. Thermophysical effects of ointments in cold: an experimental study with a skin model. Acta Derm Venereol. 1999;79(1):33–6.

    Article  CAS  PubMed  Google Scholar 

  23. Lehmuskallio E. Cold protecting ointments and frostbite. A questionnaire study of 830 conscripts in Finland. Acta Derm Venereol. 1999;79(1):67–70.

    Article  CAS  PubMed  Google Scholar 

  24. Lehmuskallio E, Rintamaki H, Anttonen H. Thermal effects of emollients on facial skin in the cold. Acta Dermato Venereol. 2000;80(3):203–7.

    Article  CAS  Google Scholar 

  25. Lehmuskallio E. Emollients in the prevention of frostbite. Int J Circumpolar Health. 2000;59(2):122–30.

    CAS  PubMed  Google Scholar 

  26. Wegener EE, Barraza KR, Das SK. Severe frostbite caused by Freon gas. South Med J. 1991;84(9):1143–6.

    Article  CAS  PubMed  Google Scholar 

  27. Sever C, Kulahci Y, Acar A, Karabacak E. Unusual hand frostbite caused by refrigerant liquids and gases. Ulus Travma Acil Cerrahi Derg. 2010;16(5):433–8.

    PubMed  Google Scholar 

  28. Uygur F, Sever C, Noyan N. Frostbite burns caused by liquid oxygen. J Burn Care Res. 2009;30(2):358–61.

    Article  PubMed  Google Scholar 

  29. Handford C, Buxton P, Russell K, et al. Frostbite: a practical approach to hospital management. Extreme Physiol Med. 2014;3:7.

    Article  Google Scholar 

  30. Millet JD, Brown RKJ, Levi B, et al. Frostbite: spectrum of imaging findings and guidelines for management. Radiographics. 2016;36(7):2154–69.

    Article  PubMed  Google Scholar 

  31. DeGroot DW, Castellani JW, Williams JO, Amoroso PJ. Epidemiology of U.S. Army cold weather injuries, 1980-1999. Aviat Space Environ Med. 2003;74(5):564–70.

    PubMed  Google Scholar 

  32. Burgess JE, Macfarlane F. Retrospective analysis of the ethnic origins of male British army soldiers with peripheral cold weather injury. J R Army Med Corps. 2009;155(1):11–5.

    Article  CAS  PubMed  Google Scholar 

  33. Candler WH, Ivey H. Cold weather injuries among U.S. soldiers in Alaska: a five-year review. Mil Med. 1997;162(12):788–91.

    Article  CAS  PubMed  Google Scholar 

  34. Tek D, Mackey S. Non-freezing cold injury in a marine infantry battalion. J Wilderness Med. 1993;4(4):353–7.

    Article  Google Scholar 

  35. Daanen HA. Finger cold-induced vasodilation: a review. Eur J Appl Physiol. 2003;89(5):411–26.

    Article  CAS  PubMed  Google Scholar 

  36. Sumner DS, Criblez TL, Doolittle WH. Host factors in human frostbite. Mil Med. 1974;141(6):454–61.

    Article  CAS  PubMed  Google Scholar 

  37. Morrison SA, Gorjanc J, Eiken O, Mekjavic IB. Finger and toe temperature responses to cold after freezing cold injury in elite alpinists. Wilderness Environ Med. 2015;26(3):295–304.

    Article  PubMed  Google Scholar 

  38. Black CE, Huang N, Neligan PC, et al. Effect of nicotine on vasoconstrictor and vasodilator responses in human skin vasculature. Am J Physiol Regul Integr Comp Physiol. 2001;281(4):R1097–104.

    Article  CAS  PubMed  Google Scholar 

  39. Kamikomaki N. A climber with the DD ACE allele developed frostbite despite taking more than adequate measures against cold on Mount Everest. High Alt Med Biol. 2007;8(2):167–8.

    Article  CAS  PubMed  Google Scholar 

  40. Blatteis CM. Physiology and pathophysiology of temperature regulation. Singapore: World Scientific; 1998.

    Book  Google Scholar 

  41. Rintamaki H. Human responses to cold. Alaska Med. 2007;49(2 Suppl):29–31.

    PubMed  Google Scholar 

  42. Darby SA, Frysztak RJ. Chapter 9—Neuroanatomy of the spinal cord. Clinical anatomy of the spine, spinal cord, and ANS. 3rd ed. Saint Louis: Mosby; 2014. p. 341–412.

    Book  Google Scholar 

  43. Keatinge WR, Cannon P. Freezing-point of human skin. Lancet. 1960;1(7114):11–4.

    Article  CAS  PubMed  Google Scholar 

  44. Mense S. 5.03—Anatomy of Nociceptors A2—Masland, Richard H. In: Albright TD, Albright TD, Masland RH, et al., editors. The senses: a comprehensive reference. New York: Academic; 2008. p. 11–41.

    Chapter  Google Scholar 

  45. Dubin AE, Patapoutian A. Nociceptors: the sensors of the pain pathway. J Clin Invest. 2010;120(11):3760–72.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  46. Hanninen OOP, Atalay M. Physiology and maintenance—volume I: general physiology. Oxford: Eolss; 2009.

    Google Scholar 

  47. Park B, Kim SJ. Cooling the skin: understanding a specific cutaneous thermosensation. J Lifestyle Med. 2013;3(2):91–7.

    PubMed  PubMed Central  Google Scholar 

  48. Voets T, Droogmans G, Wissenbach U, Janssens A, Flockerzi V, Nilius B. The principle of temperature-dependent gating in cold- and heat-sensitive TRP channels. Nature. 2004;430(7001):748–54.

    Article  CAS  PubMed  Google Scholar 

  49. Braverman IM. The cutaneous microcirculation. J Investig Dermatol Symp Proc. 2000;5(1):3–9.

    Article  CAS  PubMed  Google Scholar 

  50. Walløe L. Arterio-venous anastomoses in the human skin and their role in temperature control. Temperature. 2016;3(1):92–103.

    Article  Google Scholar 

  51. Sherman JL Jr. Normal arteriovenous anastomoses. Medicine. 1963;42(4):247–68.

    Article  PubMed  Google Scholar 

  52. Gray H, Lewis W. Anatomy of the human body. Philadelphia: Lea & Febiger.

    Google Scholar 

  53. Roddie IC. Circulation to skin and adipose tissue. In: Terjung R (ed) Comprehensive physiology; 2011. Wiley. https://doi.org/10.1002/cphy.cp020310.

  54. Brajkovic D, Ducharme MB. Facial cold-induced vasodilation and skin temperature during exposure to cold wind. Eur J Appl Physiol. 2006;96(6):711–21.

    Article  PubMed  Google Scholar 

  55. Ducharme MB, VanHelder WP, Radomski MW. Cyclic intramuscular temperature fluctuations in the human forearm during cold-water immersion. Eur J Appl Physiol Occup Physiol. 1991;63(3–4):188–93.

    Article  CAS  PubMed  Google Scholar 

  56. Gardner CA, Webb RC. Cold-induced vasodilatation in isolated, perfused rat tail artery. Am J Physiol. 1986;251(1 Pt 2):H176–81.

    CAS  PubMed  Google Scholar 

  57. Freedman RR, Sabharwal SC, Moten M, Migaly P. Local temperature modulates alpha 1- and alpha 2-adrenergic vasoconstriction in men. Am J Physiol. 1992;263(4 Pt 2):H1197–200.

    CAS  PubMed  Google Scholar 

  58. Wong BJ, Hollowed CG. Current concepts of active vasodilation in human skin. Temperature. 2017;4(1):41–59.

    Article  Google Scholar 

  59. Charkoudian N. Skin blood flow in adult human thermoregulation: how it works, when it does not, and why. Mayo Clin Proc. 2003;78(5):603–12.

    Article  PubMed  Google Scholar 

  60. Cheng MDC, Matsukawa MDT, Sessler MD, Daniel I, et al. Increasing mean skin temperature linearly reduces the core-temperature thresholds for vasoconstriction and shivering in humans. Anesthesiology. 1995;82(5):1160–8.

    Article  CAS  PubMed  Google Scholar 

  61. Nygaard RM, Whitley AB, Fey RM, Wagner AL. The Hennepin score: quantification of Frostbite management efficacy. J Burn Care Res. 2016;37(4):e317–22.

    Article  PubMed  Google Scholar 

  62. Manson PN, Jesudass R, Marzella L, Bulkley GB, Im MJ, Narayan KK. Evidence for an early free radical-mediated reperfusion injury in frostbite. Free Radic Biol Med. 1991;10(1):7–11.

    Article  CAS  PubMed  Google Scholar 

  63. Gonzaga T, Jenabzadeh K, Anderson CP, Mohr WJ, Endorf FW, Ahrenholz DH. Use of intra-arterial thrombolytic therapy for acute treatment of frostbite in 62 patients with review of thrombolytic therapy in frostbite. J Burn Care Res. 2016;37(4):e323–34.

    Article  PubMed  Google Scholar 

  64. Groechenig E. Treatment of frostbite with iloprost. Lancet. 1994;344(8930):1152–3.

    Article  CAS  PubMed  Google Scholar 

  65. Skolnick AA. Early data suggest clot-dissolving drug may help save frostbitten limbs from amputation. JAMA. 1992;267(15):2008–10.

    Article  CAS  PubMed  Google Scholar 

  66. Nagpal BM, Sharma R. Cold injuries: the chill within. Med J Armed Forces India. 2004;60(2):165–71.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  67. Gross EA, Moore JC. Using thrombolytics in frostbite injury. J Emerg Trauma Shock. 2012;5(3):267–71.

    Article  PubMed  PubMed Central  Google Scholar 

  68. McCauley RL, Hing DN, Robson MC, Heggers JP. Frostbite injuries: a rational approach based on the pathophysiology. J Trauma. 1983;23(2):143–7.

    Article  CAS  PubMed  Google Scholar 

  69. Waris T, Kyosola K. Cold injury of the rat skin. A fluorescence histochemical study of adrenergic nerves, mast cells and patency of cutaneous blood vessels. Scand J Plast Reconstr Surg. 1982;16(1):1–9.

    Article  CAS  PubMed  Google Scholar 

  70. Ozyazgan I, Tercan M, Melli M, Bekerecioglu M, Ustun H, Gunay GK. Eicosanoids and inflammatory cells in frostbitten tissue: prostacyclin, thromboxane, polymorphonuclear leukocytes, and mast cells. Plast Reconstr Surg. 1998;101(7):1881–6.

    Article  CAS  PubMed  Google Scholar 

  71. Cheng Y, Austin SC, Rocca B, et al. Role of prostacyclin in the cardiovascular response to thromboxane A2. Science. 2002;296(5567):539–41.

    Article  CAS  PubMed  Google Scholar 

  72. McIntosh SE, Opacic M, Freer L, et al. Wilderness Medical Society practice guidelines for the prevention and treatment of frostbite: 2014 update. Wilderness Environ Med. 2014;25(4 Suppl):S43–54.

    Article  PubMed  Google Scholar 

  73. Kemp SS, Dalinka MK, Schumacher H. Acro-osteolysis: etiologic and radiological considerations. JAMA. 1986;255(15):2058–61.

    Article  CAS  PubMed  Google Scholar 

  74. Twomey JA, Peltier GL, Zera RT. An open-label study to evaluate the safety and efficacy of tissue plasminogen activator in treatment of severe frostbite. J Trauma. 2005;59(6):1350–4; discussion 1354-1355.

    Article  CAS  PubMed  Google Scholar 

  75. Bruen KJ, Ballard JR, Morris SE, Cochran A, Edelman LS, Saffle JR. Reduction of the incidence of amputation in frostbite injury with thrombolytic therapy. Arch Surg. 2007;142(6):546–53.

    Article  CAS  PubMed  Google Scholar 

  76. Musiał J, Wilczyńska M, Sładek K, Cierniewski CS, Nizankowski R, Szczeklik A. Fibrinolytic activity of prostacyclin and iloprost in patients with peripheral arterial disease. Prostaglandins. 1986;31(1):61–70.

    Article  PubMed  Google Scholar 

  77. Raman SR, Jamil Z, Cosgrove J. Magnetic resonance angiography unmasks frostbite injury. Emerg Med J. 2011;28(5):450.

    Article  CAS  PubMed  Google Scholar 

  78. Barker JR, Haws MJ, Brown RE, Kucan JO, Moore WD. Magnetic resonance imaging of severe frostbite injuries. Ann Plast Surg. 1997;38(3):275–9.

    Article  CAS  PubMed  Google Scholar 

  79. Cauchy E, Marsigny B, Allamel G, Verhellen R, Chetaille E. The value of technetium 99 scintigraphy in the prognosis of amputation in severe frostbite injuries of the extremities: a retrospective study of 92 severe frostbite injuries. J Hand Surg Am. 2000;25(5):969–78.

    Article  CAS  PubMed  Google Scholar 

  80. Ikawa G, dos Santos PA, Yamaguchi KT, Stroh-Recor C, Ibello R. Frostbite and bone scanning: the use of 99m-labeled phosphates in demarcating the line of viability in frostbite victims. Orthopedics. 1986;9(9):1257–61.

    CAS  PubMed  Google Scholar 

  81. Kraft C, Millet JD, Agarwal S, et al. SPECT/CT in the evaluation of Frostbite. J Burn Care Res. 2017;38(1):e227–34.

    Article  PubMed  Google Scholar 

  82. Masters T, Omodt S, Gayken J, et al. Microangiography to monitor treatment outcomes following severe Frostbite injury to the hands. J Burn Care Res. 2017;39:162–7.

    Google Scholar 

  83. Su CW, Lohman R, Gottlieb LJ. Frostbite of the upper extremity. Hand Clin. 2000;16(2):235–47.

    CAS  PubMed  Google Scholar 

  84. Heil K, Thomas R, Robertson G, Porter A, Milner R, Wood A. Freezing and non-freezing cold weather injuries: a systematic review. Br Med Bull. 2016;117(1):79–93.

    Article  PubMed  Google Scholar 

  85. Robson MC, Heggers JP. Evaluation of hand frostbite blister fluid as a clue to pathogenesis. J Hand Surg Am. 1981;6(1):43–7.

    Article  CAS  PubMed  Google Scholar 

  86. Handford C, Thomas O, Imray CHE. Frostbite. Emerg Med Clin North Am. 2017;35(2):281–99.

    Article  PubMed  Google Scholar 

  87. Heggers JP, Robson MC, Manavalen K, et al. Experimental and clinical observations on frostbite. Ann Emerg Med. 1987;16(9):1056–62.

    Article  CAS  PubMed  Google Scholar 

  88. Bilgiç S, Özkan H, Özenç S, Safaz I, Yildiz C. Treating frostbite. Can Fam Physician. 2008;54(3):361–3.

    PubMed  PubMed Central  Google Scholar 

  89. Heggers JP, Pelley RP, Robson MC. Beneficial effects of aloe in wound healing. Phytother Res. 1993;7(7):S48–52.

    Article  Google Scholar 

  90. Obeng MK, Motykie GD, Dastgir A, McCauley RL, Heggers JP. Aloe vera in thermal and frostbite injuries. Aloes. 2004;11:251–64.

    Google Scholar 

  91. Miller MB, Koltai PJ. Treatment of experimental frostbite with pentoxifylline and aloe vera cream. Arch Otolaryngol Head Neck Surg. 1995;121(6):678–80.

    Article  CAS  PubMed  Google Scholar 

  92. Parks WM, Hoak JC, Czervionke RL. Comparative effect of ibuprofen on endothelial and platelet prostaglandin synthesis. J Pharmacol Exp Ther. Nov 1981;219(2):415–9.

    CAS  PubMed  Google Scholar 

  93. Hallam MJ, Cubison T, Dheansa B, Imray C. Managing frostbite. BMJ. 2010;341:c5864.

    Article  PubMed  Google Scholar 

  94. Salimi Z, Wolverson MK, Herbold DR, Vas W, Salimi A. Treatment of frostbite with i.v. streptokinase: an experimental study in rabbits. Am J Roentgenol. 1987;149(4):773–6.

    Article  CAS  Google Scholar 

  95. Zdeblick TA, Field GA, Shaffer JW. Treatment of experimental frostbite with urokinase. J Hand Surg Am. 1988;13(6):948–53.

    Article  CAS  PubMed  Google Scholar 

  96. Ehrman ML, Jaffe EA. Prostacyclin (PGI2) inhibits the development in human platelets of ADP and arachidonic acid-induced shape change and procoagulant activity. Prostaglandins. 1980;20(6):1103–16.

    Article  CAS  PubMed  Google Scholar 

  97. Turker RK, Demirel E. Iloprost maintains acetylcholine relaxations of isolated rabbit aortic strips submitted to hypoxia. Pharmacology. 1988;36(3):151–5.

    Article  CAS  PubMed  Google Scholar 

  98. Kawald A, Burmester GR, Huscher D, Sunderkotter C, Riemekasten G. Low versus high-dose iloprost therapy over 21 days in patients with secondary Raynaud’s phenomenon and systemic sclerosis: a randomized, open, single-center study. J Rheumatol. 2008;35(9):1830–7.

    CAS  PubMed  Google Scholar 

  99. Piaggesi A, Vallini V, Iacopi E, et al. Iloprost in the management of peripheral arterial disease in patients with diabetes mellitus. Minerva Cardioangiol. 2011;59(1):101–8.

    CAS  PubMed  Google Scholar 

  100. Whittle BJ, Silverstein AM, Mottola DM, Clapp LH. Binding and activity of the prostacyclin receptor (IP) agonists, treprostinil and iloprost, at human prostanoid receptors: treprostinil is a potent DP1 and EP2 agonist. Biochem Pharmacol. 2012;84(1):68–75.

    Article  CAS  PubMed  Google Scholar 

  101. Fetalvero KM, Shyu M, Nomikos AP, et al. The prostacyclin receptor induces human vascular smooth muscle cell differentiation via the protein kinase A pathway. Am J Physiol Heart Circ Physiol. 2006;290(4):H1337–46.

    Article  CAS  PubMed  Google Scholar 

  102. Zavoico GB, Feinstein MB. Cytoplasmic Ca2+ in platelets is controlled by cyclic AMP: antagonism between stimulators and inhibitors of adenylate cyclase. Biochem Biophys Res Commun. 1984;120(2):579–85.

    Article  CAS  PubMed  Google Scholar 

  103. Cauchy E, Cheguillaume B, Chetaille E. A controlled trial of a prostacyclin and rt-PA in the treatment of severe frostbite. N Engl J Med. 2011;364(2):189–90.

    Article  CAS  PubMed  Google Scholar 

  104. Lindford A, Valtonen J, Hult M, et al. The evolution of the Helsinki frostbite management protocol. Burns. 2017;43:1455–63.

    Article  PubMed  Google Scholar 

  105. Roche-Nagle G, Murphy D, Collins A, Sheehan S. Frostbite: management options. Eur J Emerg Med. 2008;15(3):173–5.

    Article  PubMed  Google Scholar 

  106. Cauchy E, Davis CB, Pasquier M, Meyer EF, Hackett PH. A new proposal for management of severe frostbite in the Austere environment. Wilderness Environ Med. 2016;27(1):92–9.

    Article  PubMed  Google Scholar 

  107. Poole A, Gauthier J. Treatment of severe frostbite with iloprost in northern Canada. Can Med Assoc J. 2016;188(17–18):1255–8.

    Article  Google Scholar 

  108. Torley HI, Madhok R, Capell HA, et al. A double blind, randomised, multicentre comparison of two doses of intravenous iloprost in the treatment of Raynaud’s phenomenon secondary to connective tissue diseases. Ann Rheum Dis. 1991;50(11):800–4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  109. Thom SR. Hyperbaric oxygen—its mechanisms and efficacy. Plast Reconstr Surg. 2011;127(Suppl 1):131S–41S.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  110. Ward MP, Garnham JR, Simpson BR, Morley GH, Winter JS. Frostbite: general observations and report of cases treated by hyperbaric oxygen. Proc R Soc Med. 1968;61(8):787–9.

    CAS  PubMed  PubMed Central  Google Scholar 

  111. Cooke JN. Hyperbaric oxygen treatment in the Royal Air Force. Proc R Soc Med. 1971;64(9):881–2.

    CAS  PubMed  PubMed Central  Google Scholar 

  112. Ledingham IM. Some clinical and experimental applications of high pressure oxygen. Proc R Soc Med. 1963;56:999–1002.

    CAS  PubMed  PubMed Central  Google Scholar 

  113. Gage AA, Ishikawa H, Winter PM. Experimental frostbite. The effect of hyperbaric oxygenation on tissue survival. Cryobiology. 1970;7(1):1–8.

    Article  CAS  PubMed  Google Scholar 

  114. Hardenbergh E. Hyperbaric oxygen treatment of experimental frostbite in the mouse. J Surg Res. 1972;12(1):34–40.

    Article  CAS  PubMed  Google Scholar 

  115. Uygur F, Noyan N, Sever C, Gümüş T. The current analysis of the effect of hyperbaric oxygen therapy on the frostbitten tissue: experimental study in rabbits. Central Eur J Med. 2009;4(2):198–202.

    Google Scholar 

  116. von Heimburg D, Noah EM, Sieckmann UP, Pallua N. Hyperbaric oxygen treatment in deep frostbite of both hands in a boy. Burns. 2001;27(4):404–8.

    Article  Google Scholar 

  117. Finderle Z, Cankar K. Delayed treatment of frostbite injury with hyperbaric oxygen therapy: a case report. Aviat Space Environ Med. 2002;73(4):392–4. PMID 11 952 063. Vol 732002.

    PubMed  Google Scholar 

  118. Lansdorp CA, Roukema GR, Boonstra O, Dokter J. Delayed treatment of frostbite with hyperbaric oxygen: a report of two cases. Undersea Hyperbaric Med. 2017;44(4):365–9.

    Article  Google Scholar 

  119. Dwivedi DA, Alasinga S, Singhal S, Malhotra VK, Kotwal A. Successful treatment of frostbite with hyperbaric oxygen treatment. Indian J Occup Environ Med. 2015;19(2):121–2.

    Article  PubMed  PubMed Central  Google Scholar 

  120. Taylor MS. Lumbar epidural sympathectomy for frostbite injuries of the feet. Mil Med. Aug 1999;164(8):566–7.

    Article  CAS  PubMed  Google Scholar 

  121. Khan MI, Tariq M, Rehman A, Zafar A, Sheen SN. Efficacy of cervicothoracic sympathectomy versus conservative management in patients suffering from incapacitating Raynaud’s syndrome after frost bite. JAMC. 2008;20(2):21–4.

    PubMed  Google Scholar 

  122. Snider RL, Porter JM. Treatment of experimental frostbite with intra-arterial sympathetic blocking drugs. Surgery. 1975;77(4):557–61.

    CAS  PubMed  Google Scholar 

  123. Engkvist O. The effect of regional intravenous guanethidine block in acute frostbite. Case report. Scand J Plast Reconstr Surg. 1986;20(2):243–5.

    Article  CAS  PubMed  Google Scholar 

  124. Mills WJ, Frostbite J. A discussion of the problem and a review of the Alaskan experience. 1973. Alaska Med. 1993;35(1):29–40.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Sarvesh Logsetty .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Nguyen, C.M., Chandler, R., Ratanshi, I., Logsetty, S. (2020). Frostbite. In: Jeschke, M., Kamolz, LP., Sjöberg, F., Wolf, S. (eds) Handbook of Burns Volume 1. Springer, Cham. https://doi.org/10.1007/978-3-030-18940-2_42

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-18940-2_42

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-18939-6

  • Online ISBN: 978-3-030-18940-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics