The degree of frostbite (frostbite)
Depending on the depth of skin lesions, four degrees of frostbite are distinguished. The first two degrees are considered superficial, the next two are deep.
Frostbite classification
In the diagnosis of frostbite, the classification serves as an aid in the further treatment of the patient, determining the features of the therapy of the disease.
With frostbite of the first degree, a circulatory disorder occurs, tissue necrosis does not occur. The patient complains of pain in the area of damage to the skin, which can be burning and very severe at the time of warming. Over time, in a warm room, the skin turns red and becomes warm. At the site of frostbite, there is a slight edema that does not spread to healthy tissues. Skin sensitivity and joint mobility are preserved. On the fifth or seventh day, the symptoms of the disease disappear.
With frostbite of the second degree, the skin itches, burns, its tissues are tense. The symptoms persist for several days. Bubbles form at the site of damage, in most cases this occurs on the first day, less often on the second, third or fifth day. The bubbles contain transparent contents. After the blisters are removed, the red papillary layer opens up, which may be covered with fibrin. The bottom of the bladder is very painful. The swelling of the tissues extends beyond the affected area on the skin.
Third degree frostbite is more severe and symptoms persist for a long time. Similar damage to the skin occurs after prolonged exposure to cold. In the reactive period, the skin is cyanotic and cold. Bubbles appear infrequently, there is hemorrhagic contents inside them. Extensive edema forms in the first hours or days and spreads to healthy areas of the skin, skin sensitivity is completely lost. The bottom of the bubbles is of a blue-purple hue, it does not respond to injections, and the pain reaction does not appear even after contact with a cotton swab soaked in alcohol. Over time, the tissues become necrotic, then a scar forms at the site of their rejection.
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On the first day, frostbite of the third degree practically does not differ from frostbite of the last degree. The damaged skin is pale or cyanotic. Skin sensitivity disappears completely, the limbs are cool to the touch. In the first hours, flabby blisters with dark hemorrhagic contents are formed. Edema develops rapidly (the first two hours after the onset of rewarming) and spreads to the entire limb, its area is much larger than the area of necrosis. At the next stage, dry or wet gangrene of the limbs begins. It is rather difficult to distinguish between the last two degrees of frostbite on the first day. Only a week later, after the edema subsides, does the demarcation line become noticeable, delimiting the damaged tissue from the healthy one, this symptom is considered the most characteristic of the fourth degree of frostbite.
Article author: Mochalov Pavel Alexandrovich | d. m. n. therapist
Education: Moscow Medical Institute. IM Sechenov, specialty - "General Medicine" in 1991, in 1993 "Occupational Diseases", in 1996 "Therapy".
