What are the possible complications of frostbite?

Updated: Jul 29, 2019
  • Author: Bobak Zonnoor , MD; Chief Editor: Dirk M Elston, MD  more...
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Answer

The degree of long-term disability is related to the severity of frostbite injury. An increased risk of frostbite with lesser exposures and poor cold tolerance in the previously injured extremity are commonplace. Permanent sensory loss is also common.

Wound infection, which is observed in 30% of patients, may be caused by Staphylococcus aureus, beta-hemolytic streptococci, gram-negative bacilli, or anaerobes and may present with the following:

  • Increased pain, swelling, redness, and fever

  • Red streaks extending from area

  • Pus discharge

Other complications may include the following:

  • Tetanus

  • Tissue loss and gangrene

  • Bacteremia

  • Lymphedema

  • Fascial compartment syndrome [35]

  • Irreversible growth plate injury (ie, destruction, fragmentation, or fusion of epiphyses) leading to growth deformities and postinjury arthritis [36]

  • Premature closure of growth plates, the extent of which is related to the severity of the frostbite

  • Premature closure in the digits, more frequently occurring in a distal-to-proximal direction

  • Complex regional pain syndrome

  • Altered thermal perception at the injury site, especially cold sensitivity

  • Hyperesthesia

  • Hyperhidrosis

  • Squamous cell carcinoma development at the frostbitten area

  • Hyperglycemia

  • Acidosis

  • Refractory dysrhythmias

  • Death, in very rare cases


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