It occurs relatively often, especially the protruding parts of the face (nose, auricle, cheekbone, chin). There are four degrees of frostbite.
Clinic of frostbite face
With frostbite of the 1st degree, hyperemia, cyanosis, often marbling of the skin, swelling, itching, paresthesia (pass after 3 to 7 days) are observed. Frostbites of the II degree are characterized by death and detachment of the epidermis, the formation of blisters filled with hemorrhagic fluid, swelling. The duration of treatment is 10-15 days. At the III degree – necrosis of the entire thickness of the skin, blisters with the same contents can also form, then a necrotic scab appears, demarcation occurs by the 7-8th day, areas of necrosis are rejected, and a granulating wound is formed. IV degree is characterized by damage to the cartilage of the nose, auricle. Bones of the face during frostbite are usually not affected.
Quick warming during frostbite of the first degree, careful massage of the skin with a flannel or washing with warm water, followed by treatment with alcohol, 5% alcohol solution of tannin or 2% iodine tincture, and then with indifferent fat, after which an aseptic dressing is applied. You can not rub the skin with snow, as the duration of tissue hypothermia increases and the severity of the lesion increases. When frostbite of the II degree is recommended massage of the intact areas near the affected skin (you can not damage the blisters and infect the skin), after which ointment dressings, emulsions containing antibiotics or sulfonamide preparations are applied. When frostbite of the III degree, the affected surface is treated with 5% iodine tincture, dried with aseptic dressings or resort to open treatment, achieving mummification and rejection of dead tissue. In all cases of frostbite, anti-tetanus serum must be administered.
Frostbite of the oral mucosa
It is observed extremely rarely when drinking vodka or alcohol in severe frosts. The liquid, cooled to 35 – 40 ° C and below, as if burns the mucous membrane of the hard palate, pharynx and tongue (I – II degree). At the same time, the mucous membrane is sharply hyperemic, in places there are painful small vesicles that look outwardly reminiscent of diffuse stomatitis.
The diagnosis is clarified by a survey. Treatment comes down to the usual methods of treating stomatitis and a non-irritating diet.
Isolated frostbite of the tongue is rarely observed, usually in children with inappropriate jokes (an attempt to lick an ax, a door bracket, etc.). In such cases, the back of the tongue adheres to the cooled object and, having lost the epidermis, is a bleeding wound surface.
Treatment. Shady therapy with the use of oil emulsions with antibiotics, non-irritating diet, administration of tetanus toxoid.