frostbite
Introduction
Introduction to frostbite Frostbite is a localized inflammatory damage caused by cold. Frostbite is a common disease in winter, especially in children, women and the elderly. Once frostbite occurs, it is often difficult to cure quickly in the cold season. Healing, the key to reducing the occurrence of frostbite is to start prevention before winter. Cold is the main cause of frostbite. The cause of the disease is that the skin of patients with frostbite suffers from cold (0 ~ 10 °C), wet or rapid changes in temperature, local small arteries contract, long-term arterial vasospasm and expansion, venous congestion, local blood circulation is poor. basic knowledge The proportion of illness: 0.21% Susceptible people: no special people Mode of infection: non-infectious Complications: swelling
Cause
Causes of frostbite
Cold (36%):
Cold is the most common cause of this disease. It can increase the factors of cold conduction and convection to promote the formation of this disease, such as moisture and wind speed. In addition, the ability of the body tissue to adapt to cold is also very important for the formation of this disease. The role of the body is an abnormal reaction to the cold. The frostbite is a localized skin inflammation caused by cold during the winter or early spring, which occurs in the distal part of the limb and the exposed parts, such as the hands, feet, nose, and ears. Ear and cheeks.
Poor skin cold resistance (30%):
Modern medicine believes that frostbite is caused by poor cold tolerance of the skin of the patient, coupled with cold invasion, causing contraction or sputum of the skin of the peripheral skin, leading to local blood circulation disorder, resulting in tissue damage caused by oxygen and nutrient deficiency. The occurrence is due to the lack of yang in the patient, the feeling of cold and dampness, making the blood run poorly, and the blood stasis is blocked.
As we all know, the hands and feet and the auricle are the distal part of the human blood circulation, and it is also a good site for frostbite. After the late autumn, the temperature suddenly drops, and the blood flow in the peripheral blood vessels also becomes slow. When the temperature is lower than 10 degrees Celsius, the above The subcutaneous arterioles in the site are cold contracted, the venous return is not smooth, and frostbite occurs. Some patients are caused by congenital variability of blood vessels, and blood vessels are narrowed to cause frostbite. Therefore, prevention of frostbite should be based on its pathogenesis. Taking measures in advance often has a multiplier effect.
Pathological changes (25%):
Cold causes skin vasoconstriction, local skin ischemia and hypoxia, metabolic disorders, long-term vasospasm dilatation, congestion, plasma exudation causes local tissue edema, blister formation, and tissue necrosis, ulcer formation, moisture and wind speed can accelerate surface heat dissipation, Therefore, the incidence of frostbite in humid and windy areas in winter is higher than that in dry areas. In addition, autonomic nervous disorders, poor blood supply in the extremities, excessive tightness in footwear, excessive sweating of hands and feet, lack of exercise, malnutrition, anemia and some chronic diseases are often Cause of illness.
Prevention
Frostbite prevention
Strengthen exercise and nutrition, enhance physical fitness, promote blood circulation, improve the body's adaptability to cold, pay attention to local warmth in cold season, gloves, shoes and socks should not be too tight, frozen parts should not be immediately baked and soaked with hot water; Rub the petrolatum or other oils and fats in the cold area to protect the skin. Regular local massage and warm water bath are used to improve blood circulation.
1. Soak the affected area with hot salt water for 15 minutes for 1 week.
2. "Thirty drops of water" outside the frostbite, 6 to 10 times a day, for the frostbite is not broken, the effect is better; if the local skin ulceration, can be rubbed with erythromycin ointment, after the inflammation is dissipated, then use ten Dripping water.
3. When the frostbite has just started, use the hair dryer to blow the side every night, and there will be no more after a few days.
4. Apply a topical treatment of skin redness and swelling, consciously itchy or burning painful frostbite, and achieve good results by first washing the affected area with warm water, and drying the ointment on the affected skin. Generally, it can be cured within 24 hours. If it is not cured, it can be replaced several times. If the skin is broken or allergic, it should not be applied.
5. There are many ways to cure frostbite, but it often takes a long time and has a slow effect. However, it is effective to treat with Yunnan Baiyao. The method is: if the frostbite is not broken, use Yunnan liquor to adjust the Yunnan white medicine powder into a paste-like external application, and pay attention to the insulation. If the frostbite has been broken, the affected area will be washed directly, and the Yunnan white medicine powder will be directly sprayed on the wound surface, and wrapped with sterile gauze, which can be cured within a few days.
6. Injury and painkiller cream for the treatment of frostbite: Injury and painkiller cream can be used for skin redness and itching caused by unbroken frostbite. Wash it with hot water first, then apply plaster, once a day, 2 ~3 times will work.
7. Orthopaedic water has its new use. It has special effects on frostbite. It can be rubbed 3~4 times a day. After three times of rubbing, it can eliminate the blistering block. After half a month, it can cure frostbite. Patients with frostbite may wish to try it.
8. Wind oil essence treatment of frostbite: wash the affected area, take a little bit of this product to the affected area, then gently rub it by hand until local fever, 3 times a day for 3 weeks, suitable for the beginning of frostbite, local redness and swelling Painful, but frostbite ulceration should not be used. In the winter, take a little bit of this product every day to prevent frostbite. In addition, use bone water.
9. When eating cucumber in summer and autumn, use guaty to repeatedly rub the parts of frostbite that often occur. As long as you stick to it often, you can't relapse.
10. Banana: After washing the affected area with hot water every night, peel the banana and use the banana meat to rub the cleft palate. Do not wash the affected area after rubbing, 1~2 times a day, several days.
Complication
Frostbite complications Complications swelling
Third-degree frostbite, sometimes with concurrent infection.
The symptoms of frostbite are local itching, bloating and burning, especially when it is sleeping in a warm bed. It will cause pain when there is an ulcer. The frostbite will heal when it blooms in spring, but it is easy to relapse in winter. .
Symptom
Frostbite symptoms Common symptoms Finger frostbite face frostbite "frozen" phenomenon bloating qi and blood stasis nail frostbite foot frostbite hand frostbite hand sweaty
Typical skin lesions are limited finger cover, broad bean size, dark purple red edema edema or induration, unclear boundary, bright red edge, central blue-purple, shiny surface, cold touch, fading of pressure, after pressing Slow recovery, severe swelling, surface blister formation, containing pale yellow or bloody serum, rupture or ulceration after blister formation, multiple symmetry occurs in the distal extremities with fingers, back, foot, heel, cheek , auricles and other places more common, can also occur unilaterally, mostly in children and young women, more common in the limbs of poor blood transport and sweating of hands and feet, consciously itchy, burning, swelling, itching feel hot After the exacerbation, people with erosion or ulcers consciously pain, every year in the winter, self-healing after a warm day, the course of disease is prolonged.
According to its clinical manifestations and good times in winter, it is not difficult to make a diagnosis.
TCM pathogenesis and syndrome differentiation: Chinese medicine believes that this disease is not yang, relapse of cold invasion, poor blood circulation, meridian barrier, blood stasis of the skin.
TCM syndrome differentiation: yang is not up, cold invasion, blood stasis.
Examine
Frostbite inspection
Mainly according to winter hair, common in children, women and peripheral blood transport poor and skin lesions occur in the back of the hands and feet, heels, toes, auricles and nose tips, damage varies from size to beginning, red or Fuchsia bruising erythema, the color of the fading, after the pressure, the red double slowly recovers. In severe cases, there may be suburban waters, ulcers formed after breaking, consciously local swelling, cold, itching after heat, burning or pain, after healing Often left with atrophic scars, the disease should be identified with polymorphic erythema, the latter occurs in the spring and autumn, the lesions are pleomorphic, with typical iris-like damage, often accompanied by mucosal damage, occurs in the hands and feet .
Histopathology: The lesions mainly showed dermal papilledema, perivascular mononuclear cell infiltration and vascular wall edema and vacuolization. The latter is called villous edema, and keratinocyte necrosis is common in the lower part of the epidermis.
Diagnosis
Frostbite diagnosis
The disease should be differentiated from polymorphic erythema, the latter occurs in the spring and autumn, the lesion is pleomorphic, with typical iris-like damage, often accompanied by mucosal damage, occurs in the hands and feet.
1. Polymorphous erythema: also occurs in the back of the hand, fingertips, etc., but the damage is pleomorphic, usually with typical iridescent erythema, also known as target damage, purple in the middle, reddish edges, no congestion, After the acute, more common in the spring and autumn two seasons.
2. Nodular erythema: It occurs on the side of the calf, the inflammation is obvious, the pain is severe, and no blisters and ulcers are formed, which has nothing to do with the cold season.
3. Acne cyanosis: more common in adult women, two calves cyanosis, cold skin, micro-swollen, distal coloration, no ulceration, lack of self-conscious symptoms, symptoms all year round, regardless of the season.
