Since 47% of all frostbite cases involve the foot, let's talk a little about cold weather injuries, how to identify them and how to treat them.
Cold weather injuries of the feet can be broken down into two basic categories; damp/cold and dry/cold. Damp/cold is a much more common foot injury. The reason water is so important in cold weather injuries is that it carries a higher specific heat than air. This means that water can absorb much more heat, far greater than air. As a result, damp/cold injuries are a much more common and problematic injury. Most damp/cold injuries occur at or just below the freezing point and really don't require a big drop in the mercury. Damp/cold injuries go by many names including frostnip, immersion foot, trench foot, chilblains and pernio. Dry/cold injuries, what we usually call frostbite and hypothermia, require a much colder environment to cause damage to the foot.
There's a number of ways that the body looses heat. Heat can be lost by conduction. Water is a great conductor of heat. Heat is also lost by windy conditions (convection) and contacting a cooler surface (radiation) such as standing on snow. And forget all the old tales about peppermint schnapps. Alcohol, hunger, anemia and cardiovascular disease all make you more susceptible to heat loss and cold weather injury.
The cells that make up our bodies consist of 75-85% water. In cold weather injuries, damage occurs as the water in these cells begins to freeze. Freezing results in interruption of normal cell function and eventually ruptures of the cell by expansion. Some refer to this process as dehydration of the cell. Ultimately, blood flow is arrested and even shunted away from the threatened area. Here's a comparison of dry and damp cold weather injuries;
Dry Cold Injuries (frostbite)
Typically more superficial (2-3mm) tissue damage (skin, nails, superficial subcutaneous tissues) Tissue damage more severe and obvious Damaged cells will heal over time Local wound care is necessary following the injury Infection is common
Damp Cold Injuries (immersion foot)
Tissue damage usually deep (nerves, arteries subcutaneous tissue) Damaged cells may not heal and cause chronic pain, edema and blotchy discoloration of the skin Superficial wounds (gangrene) and infections are uncommon
Prevention measures, although also obvious, are often overlooked. Remember, 30% of heat loss is from the head. It's OK to wear a hat.
The initial symptoms of cold weather injuries of the foot are obvious but often ignored. Symptoms include toes that are damp, pale cold and clammy. Swelling and maceration are common. Discomfort upon warming suggests tissue damage. After several days, bubbles and blisters may occur in cases of superficial damage. Superficial gangrene will appear over several days to a week depending upon the extent of tissue damage. Actual assessment of the damage caused by a thermal injury is often not possible until several days have lapsed following the injury.
Treatment of cold exposure and thermal injuries consists of gradual warming. Be sure to warm the feet slowly with luke warm water at approximately 104-106° F. Re-warming does not take long and can often be completed in less than 30 minutes. In severe cases, care of soft tissue gangrene and infection should be managed by your doctor. Wound care may include antibiotics, anticoagulants or other medications to reverse platelet aggregation and decrease blood viscosity. Hyperbaric oxygen and sympathetic nerve blocks are also employed to aid in wound healing. Pain management is also essential. Most surgeons will defer treatment of frostbite for several months to offer mother nature a chance to heal the majority of the injury. There is no known treatment for the long term pain following damp/cold tissue injuries.
Treatment Tips
Caution; feet that have sustained a thermal injury are unable to sense the temperature of the warm water and are therefore susceptible to burns. If you become caught outside with a cold weather injury to of the foot, wait to warm the foot until you can rest in one spot. Warming the foot and then walking distances will cause more pain and tissue damage. Delay surgical care until the wound has become well demarcated. This may mean several weeks to months following the injury.
Button up, it's cold out there.
About the author: Jeffrey A. Oster, DPM, C.Ped is a board certified foot and ankle surgeon. Dr. Oster is also board certified in pedorthics. Dr. Oster is medical director of Myfootshop.com and is in active practice in Granville, Ohio.
The latest information and news on Skin Care:
For a limited time, Oasis Skin Care in San Francisco is offering a Brazilian wax for only $35.San Francisco, CA (PRWEB) February 06, 2012 San Francisco skin spa, Oasis Skin Care, San Francisco?s announces its Valentine?s Day special: a Brazilian wax for only $35, starting Feb. 6 and running through Feb. 17. The regular price of a Brazilian wax at Oasis Skin Care is $55.?Cida is a rare gem. I had ...
New Science in Skin Care Available to Consumers
WILMINGTON, Del., Feb. 4, 2012 /PRNewswire-iReach/ -- Prolastil.comProlastil Skin Cream and Eye Serum Scientific UpdateThe products, marketed under the name , Prolastil E-50 work by increasing the amount ...
TapeRelief(TM) Replaces Multiple Products Used for Ostomy, Wound Care and Ski...
LAS VEGAS -- TapeRelief(TM), a new topical cream that provides a soothing and effective barrier between human skin and medical tape and adhesives, can replace multiple products commonly used for wound ...
Spoiler Alert! Aura Laser Skin Care Teases Top-Secret Product
Pharmaceutical skin-care line will be latest innovation for Seattle, Washington-based Aura Laser Skin Care, no stranger to breaking the dermatological mold.Seattle, WA (PRWEB) January 31, 2012 Pay no attention to that revolutionary product behind the curtain! At least, not for a few more weeks, until Aura Laser Skin Care is ready to debut what?s already being heralded as a major skin-care ...
Aura Laser Skin Care Announces Staff Additions
Busy Seattle, Washington-based Aura Laser Skin Care starts 2012 with biggest hiring spree in clinic?s history, bringing on four new estheticians to meet growing demand.Seattle, Washington (PRWEB) January 29, 2012 Aura Laser Skin Care announced today a major addition to its clinical staff, tripling its number of active medical aestheticians to better serve its rapidly increasing patient base.Katy ...
Health Tip: Wash Skin Properly
(HealthDay News) -- Good skin care can help keep it healthy, moisturized and acne-free.
Celebrate Your Skin's Natural Beauty With Avon Naturals
Get ready to start the New Year with a skip in your step and a refreshingly youthful glow! And, what better way to feel renewed and revitalized than to give your skin care regimen an invigorating boost?
Apsara Skin Care, Inc. Introduces 100% Natural Facial Toners
Apsara Skin Care, Inc., based in San Jose, California, welcomed 2012 with the launch of a new product category of facial toners. Keeping with its clean and green philosophy, all Apsara facial toners are chemical & alcohol free. They are based on rosewater, and formulated using the purest herbal and floral extracts to safely raise the beauty quotient of your skin. Detailed product information can ...
Aura Laser Skin Care Announces Record-Setting 2011
New products, unique focus helped Seattle, Washington-based Aura Laser Skin Care reach new heights in 2011, setting records for number of patients seen and number of successful treatments.Seattle, Washington (PRWEB) January 30, 2012 Aura Laser Skin Care announced today that 2011 went down as the biggest year in the clinic?s history, with new records set for number of patients treated and number ...
Skin Friendly Receives National Certification
DALLAS, Jan. 25, 2012 /PRNewswire/ -- A local business specializing in skin care solutions focused on preventing exposure to harmful elements before they can create a problem, received national certification ...