Treatment

Normal body temperature should be restored before thawing any frostbitten flesh. A small area of frostnipped skin can be rewarmed by placing fingers or the heel of the hand over the affected area. Rapid thawing of the affected part in warm water baths is the current preferred treatment method for more extensive frostnip and for frostbite. If immediate emergency help is unavailable, severely frostbitten hands or feet should be thawed in warm, not hot water (between 100° and 105°F). other heat sources (such as heating pads) should not be used because the frostbitten tissue can still be burned by temperatures that under normal conditions would not hurt the skin.

If the skin tingles and burns as it warms, circulation is returning. If numbness remains as the area is warmed, professional help should be obtained immediately.

A frostbitten area should never be rubbed as it thaws. If feet are affected, the child should not walk on them. In addition, neither bandages nor dressings should be used.

Thawing time is determined by the temperature of the water and the depth of freezing; it is complete when the extremity flushes pink or red. After rapid thawing, small blisters may appear, spontaneously rupturing in four to 10 days, followed by a black scab. Normal tissue may have formed beneath the scab. Constant exercises should be performed to preserve joint motion. Further treatment is designed to prevent infection and preserve function of the affected part.

In severe cases, antibiotics, bed rest, and physical therapy may be necessary after the affected part has been warmed. The best chance of successful healing after frostbite is if the affected part has not been frozen long, when thawing is rapid, and when blisters develop early. The outlook is more uncertain when thawing is spontaneous at room temperature, when the part is frozen for a long time, or if the frostbite occurred in an area of fracture or dislocation. A poor outlook is indicated if thawing is delayed or occurs due to excessive heat, if blisters are dark, or if thawing is followed by refreezing. Refreezing almost always ends in amputation.

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