Gelures

Frostbite is a localised lesion caused by a direct freezing action on tissues. It is characterised by a gradual onset and a local numbness that may delay its medical management. The pathophysiology of frostbite is peripheral vasoconstriction secondary to a drop in core body temperature. The mainstay of primary medical treatment is a rapid re-warming, and the use of peripheral vasodilators. New management guidelines aim to reduce progression of frostbite to progressive secondary necrosis. A recent classification based on initial lesion involvement and bone scanning data defines four stages which correlate with long-term prognosis and have useful prognostic implications. At the stages III and IV, a risk of bony amputation is associated. Late surgical treatment aims to be maximally conservative and is discussed with plastic surgeons. But in case of uncontrolled sepsis emergency surgical treatment may be needed.