Stages of Localized Cold Injury (Frostbite)

Cold injury may be local or systemic. Sheridan et al reported 3 stages of localized cold injury (frostbite).

Parameters:

(1) clinical features on presentation

(2) clinical features after rewarming

(3) perfusion

Features on Presentation	Appearance After Rewarming	Perfusion	Stage
pallor with numbness and burning	erythema	present before and after rewarming	I
pallor and insensate	blistering	present after rewarming	II
frozen and insensate	hemorrhagic blisters	present after rewarming	III
frozen and insensate	hemorrhagic blisters	none (necrosis)	III

Factors making localized cold injury worse:

(1) tobacco use

(2) diabetes and/or peripheral neuropathy

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