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A Clinical Review of the Management of Frostbite
  1. AW Grieve, General Practitioner Vocational Trainee1,
  2. P Davis, Consultant in Emergency Medicine2,
  3. S Dhillon, General Practitioner Centre for Altitude3,
  4. P Richards, General Practitioner4,
  5. D Hillebrandt, General Practitioner5 and
  6. Chris Imray, Consultant Vascular and Endovascular Surgeon and Honorary Professor3,6
  1. 1Friarage Hospital, Northallerton
  2. 216 Medical Regiment, Southern General Hospital, 1345 Govan Road, Glasgow
  3. 3Space and Extreme Environment Medicine, University College London, Institute of Child Health, 30 Guilford Street, London
  4. 4The Surgery & Travel Clinic, 64 London Road, Wickford, Essex
  5. 5Derriton House, Derriton, Holsworthy, Devon
  6. 6Warwick Medical School, University Hospitals Coventry and Warwickshire NHS Trust, Coventry
  1. Warwick Medical School, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, CV2 2DX, UK. Christopher.imray{at}


Frostbite is a thermal injury that can occur when temperatures drop low enough for tissue to freeze. On rewarming the tissues, an inflammatory process develops which is often associated with tissue loss. The extent of the tissue loss reflects the severity of the cold exposure and includes factors such as temperature, duration, wind chill, altitude, and systemic hypothermia.

This review discusses the epidemiology, the pathophysiological processes involved, and the clinical management of frostbite injuries. Practical advice is given on both the field and hospital management and how to seek expert advice from remote situations. The review also discusses newer developments in frostbite treatment such as intra-vascular thrombolysis and adjunctive treatments such as the use of intravenous vasodilators.

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