We investigated references from relevant articles, and corresponded with a trial author. We included randomised controlled trials RCTs that compared any medical intervention, e. Two authors independently extracted data. We used the Cochrane 'Risk of bias' tool to assess bias in the included trial. We assessed incidence of amputations, rates of serious and non-serious adverse events, acute pain, chronic pain, ability to perform activities of daily living, quality of life, withdrawal rate from medical therapy due to adverse events, occupational effects and mortality.
We included one, open-label randomised trial involving 47 participants with severe frostbite injuries. We judged this trial to be at high risk of bias for performance bias, and uncertain risk for attrition bias; all other risk of bias domains we judged as low. All participants underwent rapid rewarming, received mg of aspirin and mg intravascular IV buflomedil since withdrawn from practice , and were then randomised to one of three treatment groups for the following eight days.
Group 1 received additional IV buflomedil mg for one hour per day. Group 2 received the prostacyclin, iloprost, 0. The results suggest that iloprost and iloprost plus rtPA may reduce the rate of amputations in people with severe frostbite compared to buflomedil alone, RR 0.
Iloprost may be as effective as iloprost plus rtPA at reducing the amputation rate, RR 0. There were no reported deaths or withdrawals due to adverse events in any of the groups; we assessed evidence for both outcomes as being of very low quality.
Adverse events including flushing, nausea, palpitations and vomiting were common, but not reported separately by comparator arm very low-quality evidence. The included study did not measure the outcomes of acute pain, chronic pain, ability to perform activities of daily living, quality of life or occupational effects. After rewarming, the skin will be discoloured and blistered, and will eventually scab over.
If the frostbite is superficial, new pink skin will form beneath the discoloured skin and scabs. The area usually recovers within 6 months. If you have severe frostbite, you'll need to be admitted to a specialist unit where medical staff are experienced in treating these types of injuries.
This is often a specialist burns unit because exposure to very high temperatures can cause the same type of injury as exposure to very cold temperatures. If there's a high risk of major damage, you may have thrombolytic therapy tPA. Medicine to help break up small clots in the frostbitten blood vessels will be given as injections or through a drip in your arm. This should improve blood flow to the affected body part, which can stimulate healing and prevent further damage. You may also be given antibiotics to prevent the affected body part becoming infected.
Iloprost is sometimes used to treat severe frostbite. It works by widening the blood vessels that supply blood to the affected body part. When severe frostbite threatens the loss of a limb, finger or toe, a person should be considered for treatment with tPA or iloprost within 24 hours of the injury happening.
McIntosh SE, et al. Wilderness Medical Society practice guidelines for the prevention and treatment of frostbite. Bergeron MF, et al. International Olympic Committee consensus statement on thermoregulatory and altitude challenges for high-level athletes. British Journal of Sports Medicine. Miller T. Preparing for cold weather exercise. Performance Training Journal. Briggs JK.
In: Triage Protocols for Aging Adults. Wolters Kluwer; Thompson DA. American Academy of Pediatrics; Kelly AP, et al. An ice burn can develop when your skin is exposed to very cold temperatures. Learn how to prevent and treat it. A winter rash is an area of irritated skin that develops during winter, often due to dry skin.
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Stages of Frostbite. Medically reviewed by Elaine K. Luo, M. Frostbite is most common in your extremities, such as your fingers, toes, ears, and nose. Normal skin and response to cold. Frostnip: first-degree frostbite.
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