Complications
Causative organisms include Staphylococcus aureus, beta-haemolytic streptococci, gram-negative rods, and anaerobes.
Occurs due to a reduction in compartment size produced by the freezing injury.
Can be very difficult to diagnose as patients with frostbite already have many of the symptoms. A high index of suspicion should be maintained in all patients, especially if there is any worsening in condition.
Requires surgical treatment with fasciotomy.
Mummification (dry gangrene) is seen in fourth-degree injuries. Infection of necrotic tissue can lead to wet gangrene, which is an indication for early amputation.
A common complaint post-frostbite and often unresponsive to conventional analgesia. Amitriptyline or gabapentin may be of benefit, but these patients often require referral to a chronic pain specialist.[14]
Performed once the viability of the tissue is definitively assessed, usually 1 to 3 months after the initial injury.[4]
Risk factors for amputation include third- or fourth-degree injury, late presentation, lower extremity involvement, and infection of the injured tissue.
If the patient develops wet gangrene or sepsis, early amputation is required.
Previously frostbitten tissue has increased cold sensitivity and susceptibility to the tissue changes associated with frostbite.
Recurrent injury occurs more easily than the original injury and is usually more severe.
Patients should keep the injury well protected from cold; wear warm, non-restrictive clothing; and avoid extreme conditions.
Frostbite is considered to be a high-risk wound.
The administration of tetanus prophylaxis should prevent this complication in most cases.
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