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Frostbite


man in the snow

Frostbite is a tissue injury in which tissues are damaged by freezing from exposure to cold weather. Most often it is the hands, feet, nose, and ears that are affected from lack of protection. Frostbite is a problem in Denver because our weather is so mild that, when we have cold snaps, people are often caught unprepared. Frostbite is 100% preventable by wearing proper clothing such as mittens and boots and carrying winter clothing and blankets in a car, even when driving short distances. As part of our community outreach and education programs, the Burn Unit has a yearly sock drive, providing foot protection to homeless people.

Frostbite should be suspected if, after exposure to cold weather, your affected body part has lost sensation, or appears white, waxy and hard. First aid for frostbite involves protecting the skin from further damage by getting out of the cold and then slowly warming the affected parts. When you thaw the affected skin, do not use water warmer than 100 degrees Fahrenheit (37 degrees Celsius). The skin may blister, turn blue, and be extremely painful while thawing.

Treatment for frostbite has been revolutionized in the past ten years by treating acute frostbite injuries with tissue plasminogen activator, t-PA. This is the same “clot-busting” drug used for treating acute myocardial infarctions and strokes. Part of the tissue damage from frostbite is caused by clotting of the smaller arteries and veins in the tissue. T-PA opens up these vessels and prevents necrosis (cell death). When used to treat frostbite, t-PA can save digits and extremities from being amputated. However, t-PA needs to be started within 24 hours after the injury; otherwise, the tissue damage is irreversible. Therefore, prompt referral and transfer to a burn unit is essential in any suspected frostbite injury.