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Ask Dr. Dunn: Frostbite



By Maren Dunn, D.O. Health Writer

How do you prevent and treat frostbite during Montana’s frigid winters?
– Margerie, from Texas

It’s wintertime in Russia, 1812. Napoleon’s army is retreating from Moscow, crossing frigid rivers and snowy valleys. The troops survive by building fires at night and marching by day in subzero temperatures. Enter Baron Dominique Jean Larrey, Napoleon’s military surgeon.

He noted that troops suffered injuries due to cold that worsened with each episode of refreezing. While historically known as the pioneer of battlefield first aid, Jean Larrey was also the first to describe frostbite.

When body tissues are exposed to below-freezing air, water or metal for a prolonged period of time, the fluid between the cells of those tissues freezes. As this takes place, the blood vessels in the area constrict reducing the blood flow to the area. Ultimately, these cells die.

The dying cells set off an immune system reaction causing inflammation and further damage. If a frostbite injury thaws but undergoes another episode of freezing, the wound becomes more severe.

Frostbite, like burns, can be divided into two categories: superficial and deep. As with burns, a frostbite injury can worsen quickly if not treated properly. Rewarming is the primary method of treatment and outside the hospital setting, this can be accomplished with warm water or body heat. Do not rub frostbitten areas and try not to move them. Also, do not rewarm if the affected body part will undergo refreezing before receiving permanent rewarming, as this will worsen the injury.

In the hospital, rewarming is done quickly while other methods are used to restore blood flow. Like burns, dressing changes and frequent cleaning of the wounds are performed. Sometimes amputation is necessary.

When it comes to frostbite, the best management is prevention. When planning a cold weather outing, watch weather reports, dress appropriately and have an emergency plan in case you become detained. Always dress in layers so wet ones can be removed. When traveling in remote areas, let someone else know your plans and make sure to eat enough calories to sustain your energy. If you think you’ve suffered frostbite, see your doctor to make sure you heal properly.

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