Summary

• An injury produced by tissue freezing following exposure to cold.
• The degree of severity is determined by the depth of the freezing and subsequent injury.
• Diagnosis is clinical, but technetium-99 scanning can give an early indication of prognosis.
• The mainstay of treatment is rapid initial rewarming of the injured tissue.
• Wound management is similar to the management of burns and involves debridement of white blisters, regular aloe vera application, and regular hydrotherapy.
• Emerging data suggests thrombolytic therapy may be of benefit in severe frostbite if given within 24 hours of injury, but this is currently still investigational.
• It takes 1 to 3 months to determine the viability of the injured tissue.
• Risk factors for amputation include severe injury grades, late presentation, lower extremity involvement, and wound infection.