The specialty of burn care is not relegated to chemical, electrical, flame and scald injuries. At BRCA, our team of board-certified surgeons and plastic/reconstruction specialists are also trained in the most advanced treatment and management of cold injuries including thrombolytic therapy.

Cold injuries can result in temporary or permanent tissue damage caused by prolonged exposure to temperatures less than 23°F.  Injuries can range from frostnip to more complex injuries resulting in significant local tissue loss and/or limb amputations. The classification of frostbite injuries is similar to burn injuries:

First Degree

Superficial without blister formation; Frostnip

Second Degree

Light colored blisters with subsequent peeling

Third Degree

Dark blisters that evolve into thick, black eschar

Fourth Degree

Involves bone, tendon and/or muscle

A better understanding of the pathophysiology of the disease process has led to recent advancements in the treatment of frostbite. No longer considered to be a condition of simple tissue freezing, cold injuries are now recognized to be a more complex ailment associated with local tissue injury and vascular occlusion.  Today, treatments are designed to rewarm the affected tissues rapidly, while improving blood flow to the injured area with thrombolytics. Tissue plasminogen activator, commonly known as tPA and given to stroke victims, is a proven, effective treatment for frostbite injuries resulting in significantly lower amputation rates.

Patients presenting with frostbite should be viewed as a vascular emergency and immediately be referred to a burn specialist who is trained in the use of tPA. Rapid diagnosis and treatment of cold injuries can significantly reduce the morbidity associated with this injury.