Damage to tissues without freezing
Last reviewed: 23.04.2024
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Acute or chronic damage without freezing can occur due to hypothermia of the body.
Cold spasm. The most moderate degree of cold damage. The damaged area becomes numb, swollen and reddened. Treatment consists in a gradual warming, which is accompanied by pain and itching. In rare cases, moderate hypersensitivity to hypothermia persists for months and years.
Trench stop. Long exposure to cold and moisture can lead to the development of a trench foot. Peripheral nerves and vessels usually suffer; in severe cases, muscles and skin can be damaged.
At first the foot is pale, swollen, the skin is sticky, cold, stiff; possible maceration of the skin, especially if patients walk a lot. Warming up is accompanied by hyperemia, pain and often hypersensitivity to an easy touch, the symptoms persist for 6-10 weeks. The skin may ulcerate with the formation of a black scab. Characteristic development of autonomic dysfunction with increasing or decreasing sweating, vasomotor changes and local hypersensitivity to changes in ambient temperature. The muscle atrophy, sensitivity disturbances up to anesthesia can also occur and be chronicized.
It is possible to prevent the development of a trench foot by eliminating the wearing of tight shoes, keeping the feet and shoes dry, often changing socks. Direct treatment consists in warming the feet in water at a temperature of 40-42 ° C, followed by the imposition of a sterile dressing. Chronic neuropathies are difficult to treat; you can try the appointment of amitriptyline.
Frostbite (frostbite of the 1st degree). Limited areas of erythema, edema and pruritus occur due to repeated exposure to dry cold; the mechanism is not fully understood. On the skin, bubbles or ulcers may occur. Fainting usually damages the skin of the area of the fingers and antero-tibial area, passes by itself. Occasionally, relapses may occur.
The term "reforestation" is often used to refer to vascular disease, more characteristic among young women with a Raynaud phenomenon in history. Endothelial and neuronal damage leads to vessel hypersensitivity to cold and sympathetic instability. With refractory fever, nifedipine can be effective at 20 mg per day. Sympatholytics can also be effective.
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