Fourth degree frostbite followed by fingertip amputation!
In fourth degree frostbite, structures below the skin are involved like muscles, tendon, and bone. Early symptoms include a colorless appearance of the skin, a hard texture, and painless rewarming. Later, the skin becomes black and mummified. The amount of permanent damage can take one month or more to determine. Autoamputation can occur after two months. The first priority in people with frostbite should be to assess for hypothermia and other life-threatening complications of cold exposure. Before treating frostbite, the core temperature should be raised above 35C. Oral or intravenous (IV) fluids should be given. Various types of surgery might be indicated in frostbite injury, depending on the type and extent of damage. Debridement or amputation of necrotic tissue is usually delayed unless there is gangrene or systemic infection (sepsis). If symptoms of compartment syndromedevelop, fasciotomy can be done to attempt to preserve blood flow.
