

by Jeffrey Shupp, MD, Director, Burn Center
January 5, 2018

With expected low temperatures in the single digits for the D.C. area this weekend, pay attention to the early stages of frostbite. Every year, we see anywhere from a handful to dozens of patients who have tissue loss on their hands and feet from frostbite.

But a groundbreaking treatment traditionally used to save stroke patients’ lives also can be used to save frostbite victims’ extremities: blood clot-busting drugs that increase blood flow to affected limbs. The key is to seek treatment as soon as you can.

Often, individuals come to us days or even weeks after they suffered frostbite, and at that time, there’s not a lot that can be done to help the injured tissue. They then come to the Burn Center because treatment and reconstruction after the frostbite injury is similar to that of burns. The skin and the soft tissue below the skin are often destroyed from the cold. Those patients will then need grafting or amputation in order to restore function in their hands and feet.

Groundbreaking early treatment: clot-busting drugs

If treatment for frostbite is begun within the first several hours of injury, we sometimes can use clot-busting drugs typically used for people experiencing a stroke to try to save tissue in frostbitten fingers and toes. These drugs are given in the arm or the leg early after the incident of frostbite. In some studies, especially in places of colder climate, they show an improvement in saving tissues and fingers and toes.

This therapy may work because tissues become inflamed when they have been frostbitten and then are re-warmed. This inflammation is similar to clotting that blocks blood vessels. Since the drugs used for strokes break up the inflammation, blood flow is increased before permanent injury occurs. To be able to use this cutting-edge treatment, we need to see you within the first several hours of your potential frostbite.

Related reading: Dr. Shupp discusses frostbite in a WTOP Radio news article.

What are the symptoms of frostbite?

Frostbite often causes numbness or a pins-and-needles feeling in fingers and toes. Sometimes it feels more like fiery, burning pain, and this can come and go and until the extremities are back to their normal temperature. Another thing to pay attention to is color changes to hands and feet, either red, or pale color, or even blue in the nail beds.

People tend to watch and wait when they have numbness or tingling because it doesn’t seem urgent. However, by the time there are changes to their skin, it’s a bit late. Damage can be permanent. It’s better safe than sorry, so if you’ve had an extended exposure to cold temperature and you have sensory or color changes to any of your extremities that persist beyond 30 minutes, it’s time to seek professional help. Go to your local emergency room to be evaluated. If there’s an indication that you have frostbite, we at the Regional Burn Center can give you the best care possible.

Related reading: Dr. Shupp discusses frostbite prevention tips with WRC-TV (Channel 4).

With lows remaining in the single digits for the #D.C. area this weekend, pay attention to the early stages of #frostbite. via @MedStarWHC

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The best thing you can do is prevent frostbite in the first place

If you can, stay indoors when temperatures are bitterly cold. If you must go outside, wear multiple layers of loose, warm clothing. If you’re outside for extended periods, take frequent breaks to reassess how you’re feeling before going back out in the cold. Stay as dry as possible, especially when out shoveling snow, and change out of wet clothes immediately. Sweating or any other type of moisture under gloves or clothing make the frostbite process worse.

Is there a chance you could have frostbite? Call 202-877-3627.

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Category: Healthy Living     Tags: clot-busting drugsD.C.dr-jeffrey-shuppfrostbitefrostbitten