Stay warm this winter and protect your feet from prolonged exposure to the cold and wet snow. Frostbite occurs with exposure to subfreezing temperatures below 32°F. There are four phases of frostbite injury:

• Prefreeze phase: The arteries in the foot vasoconstrict, while the veins dilate causing leaking of fluid from the cells
• Freeze-Thaw Phase: crystals start to form within the cell membrane and can result in rupture of cell membranes. Damage at this phase is still reversible
• Vascular Stasis Phase: Tissue is deprived of oxygen
• Ischemic Late Phase: The injured tissue is dead and damage to nerves occurs at this point

If frostbite is caught at an early stage rapid rewarming with circulating water at 104-108°F for 20 minutes can reverse the process. Rewarming is a painful procedure and it is recommended that you seek medical attention for appropriate pain medication. It is important to avoid smoking and caffeine as they can cause vasoconstriction of the arteries. Blood thinners such as Aspirin or Heparin can be administered to increase delivery of blood flow to distal parts of the foot, such as the toes.

Frostbites in later stages cannot undergo rapid rewarming. Instead, these injuries will be left to demarcate until a debridement or amputation will be performed. In the meantime, local wound care with Betadine, Dakin’s, or Silver Sulfadiazine may be applied to the wound depending on its severity.

Frostbite is a serious injury that can lead to amputation if left untreated.  For more information come see us at Foot& Ankle Doctors, Inc.

Dr. Dardashti