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3 minutes to understand the pathogenesis and treatment of frostbite

Frozen sore refers to the damage to skin inflammation caused by the cold. Frozen sores are non -freezing cold injuries and occur in areas where winter or early spring temperatures are low and humid. The Yangtze River Basin is common. It has the characteristics of long diseases and recurrent attacks. When the onset of the disease, itching and heat pain in the hands, feet, etc., seriously affect people’s work and rest.

1. Cause

The causes of frostbite formation are divided into internal causes and external causes. The internal causes mainly refer to the functional state of the body itself, such as the sensitivity of the skin blood vessels to cold, autonomous nerve function, and genetic factors; external causes mainly refer to environmental temperature, temperature, and protective measures. Wetness can accelerate the heat dissipation, so the humidity in winter, especially in areas with temperature below 10 ° C, the incidence of frostbite is higher.

In addition, autonomous nerve dysfunction, poor blood circulation of the limb, sweating of hands and feet, lack of exercise, too tight shoe and socks, malnutrition, anemia, and some chronic consumer diseases are often the cause of frostbite.

2. pathogenesis

The mechanism of frostbite caused by cold is unknown, which may be related to the cold allergy of the skin blood vessels, or it may be related to autonomous nerve dysfunction and genetic factors.

When the moderate cold exposure, normal people can cause skin blood vessel contraction, followed by vascular expansion to maintain blood flow. Patients with frostbite have thicker skin arteries persistent spasm and contraction. The thinner surface shallow vascular durability expansion, producing blood stasis, hypoxia for local tissue, leading to damage to tissue cells. If the duration is longer, the internal and external environment changes, the vascular paralysis can be expanded, the venous congestion, the permeability increases, and the plasma penetration into the tissue gap causes edema.

Third, clinical typing

There are two types of human damage caused by low temperature: one type is called non -freezing cold injury, and the other is called freezing cold injury. Non -freezing cold injuries are caused by low temperatures from 10 ° C to more than freezing points, such as frostbite, trenches, and immersion feet. Frozen sores are a type of non -frozen cold injury. The degree of frostbite can be divided into the following 3 degrees.

Ⅰ degree (erythema frostbite): shallow skin frostbite. Local skin is white, and then red and swollen, there can be local itching, tingling, and abnormal sensation.

Ⅱ degree (blister frostbite): full -layer frostbite. Damage to the deep skin, the local redness and swelling are obvious, blisters can occur, serum -like or bloody liquids in the inside. The pain is severe. The blisters are dry within a few days.

Ⅲ degree (necrotic frostbite): skin and subcutaneous tissue frostbite. Its damage to deep skin, subcutaneous tissue or muscle skeletal, mostly blisters appeared 3 to 7 days after the injury, the damage parts were purple and black, the surrounding tissue was edema, the pain was obvious, the limb activity was limited. The function is completely lost, and the wound is slower; after 2 to 3 weeks, the frostbite necrosis tissue is separated from the normal tissue, leaving scars and dysfunction.

The most severe frostbite is frozen, which refers to a systemic frostbite caused by low temperature cold or exposed to the cold environment for a long time. In the early stages of frostbite of the whole body, the cold war, pale skin, cold, breathing, accelerated heartbeat, slow response, unclear consciousness, and stiffness of the whole body muscles until breathing and cycle failure. If not rescued in time, life is often endangered.

Fourth, western medicine treatment

Western medicines used to treat frostbite include three categories: vascular expansion, anticoagulation and anti -inflammatory drugs. For example, Todonine has the effect of expanding capillary and improving microcirculation. There are clinical reports that the ointment of the green ointment is applied to the affected area after grinding it with the ointment of the green ointment, and at the same time, the treatment is as high as 98%. Nifedi plastics has the effect of expanding blood vessels and improved skin microcirculation. Dicemethon has the effect of anti -infection and itching. And Fu Xilin has antibacterial and anti -inflammatory effects on erosion and inflammatory infection caused by frostbite.

5. Traditional Chinese Medicine Treatment

Traditional Chinese medicine believes that the occurrence of this disease is due to the lack of yang qi and cold and dampness of the patient, which causes the qi and blood to run poorly, and the blood stasis is blocked.

He Huiying and others use self -made compound frostbite creams such as angelica, asarum, cinnamon, dry ginger, borneol, vitamin E, and cream. 90 cases of frostbite were treated. After 10 days, the effect was ≥60%, and the validity was 30%~ 59%, and it was invalid <30%.

Ai Dongfang’s homemade Ma Yinglong Musan hemorrhoid cream (containing musk, pearl, beef, stovenite, borax, borneol) was applied to the affected area. 35 cases were cured, accounting for 76%; and effective 11 accounted for 24%. The total efficiency is 100%.

Liu Jingwei and other reciprocated reciprocated traditional Chinese medicine frostbite washing agents (Xin Yan, Baiji, safflower, Gan Song, Shanyu, aconite, and dried ginger) were scrubbed. There are 320 cases of this disease, 5 days for 1 course of treatment, 79%after the end of 1 course of treatment, and 100%after two courses.

Six, physical therapy

(1) HE-Ne laser therapy

HE-Ne laser can improve blood vessel function, weak laser irradiation has the effect of expanding blood vessels, which can enhance the micro-circulation of the accumulated parts; it can enhance the blood porting capacity of blood, increase the oxygen of the blood, increase the oxygen supply in the tissue, and help the body’s metabolism. Keeping and recovering; at the same time, it can reduce blood viscosity and prevent blood stagnation, occlusion and thrombosis in the capillary. Frozen sores are generally considered to be caused by cold stimulation, disorders, microcirculation disorders, and tissue hypoxia, so HE-Ne laser has a good effect on the treatment of frostbite.

(2) Infrared treatment

The basis of infrared therapy is the warm effect. Under infrared irradiation, tissue temperature rises, capillaries expansion, blood flow accelerate, material metabolism enhances, tissue cell vitality and regeneration capacity improvement. At the same time, infrared rays can reduce the excitement of the nervous system and have analgesic effect. For ulcerated frostbite, it has the effects of improving tissue nutrition, eliminating granulation and edema, promoting granulation growth, and accelerating wound healing. (3) Acupuncture

Acupuncture in the middle acupoint can enhance gastric motility and thickening and denseness of empty intestinal mucosa to strengthen the digestion and absorption of nutrients, so as to facilitate the healing of frostbite. Acupuncture Hegu, Waiguan and Houxi acupoints can clear the yang of hands, and the opponent’s department plays a warm role.

Seven, other diseases that cause frostbite

If frostbite repeatedly occurs and does not heal for a long time, you should also be alert to other diseases. Some literature reports that frostbite caused by chlorophyte diarrhea due to chlorophytic diarrhea, which may be caused by the increasing coldness of the peripheral blood vessels peripheral blood vessels in patients with neurological anorexia and the imbalance of body temperature regulation.

The autoimmune disease that is likely to cause frostbite is mainly systemic lupus erythematosus. Patients with systemic erythema prison sores are more likely to develop frostbite in a cold environment.

In addition, there are data that the acute seizures of chronic cellular leukemia and the metastasis of breast cancer changes to the first symptoms of skin frostbite or frostbite. A 6 -year -old single nuclear cell leukemia female patients had long -term repeated frostbite -like damage.

Reference

[1] Song Jie, Li Senhao. Development of frostbite treatment drugs [J]. Straits Pharmacy, 2017, 29 (04): 81-83.

[2]LorenzoVillalbaNoel,AndresEmmanuel,GuerreroNi?oJavier,NascoEdward, Cattelan Jessy, Jannot  Xavier,Ledoux  MariePierre.Frostbite and Cold Agglutinin Disease:Coexistence of Two Entities Leading to Poor Clinical Outcomes [J].Medicina,2021,57(6): 592-592.

<!-2528: Dermatology terminal page

[3] Gupta Aanchaal and Soni Rajat and Ganguli Munia.frostBite – Manifestation and Mitigation [J]. Burns Open, 2021, doi: 10.1016 /j. Bur NSO.2021.04.002.

[4] Xu Xiaoguang, Gu Jun. The cause and prevention of frostbite [J]. People’s Military Medicine, 2006, 49 (12): 700-702.

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