Prolonged exposure to low temperatures combined with tight shoes leads to peripheral vascular spasm and local circulatory disorders in the feet. The heel area, devoid of a dense fat layer and subject to constant pressure when walking, suffers from cold ischemia one of the first.
Ignoring the primary symptoms of freezing triggers the process of tissue necrosis. The restoration of damaged epidermis requires a competent medical approach, as mistakes in first aid exacerbate cell destruction and lead to the formation of deep trophic ulcers.
Diagnosis and stages of cold injury
The visual pattern of frostbite changes as the limb warms up. In the reactive period, when the temperature of the tissues begins to rise, blood flow is restored, which is accompanied by acute pain, swelling and pigmentation changes. The depth of necrosis determines the severity of the injury and the tactics of further therapy.
The symptoms of a cold injury are divided into several distinct stages:
- paleness of the skin with complete loss of sensitivity and subsequent redness;
- the appearance of transparent bubbles with serous fluid on the background of purple epidermis;
- the formation of bloody blisters and the death of the germ layer of the dermis.
With the first and second degree of frostbite, tissue regeneration is possible by conservative methods at home. The appearance of hemorrhagic exudate or blackening of the heel areas signals irreversible changes that require immediate surgical intervention to excise necrotic masses.
Self-piercing of blisters on the heels is strictly prohibited. Violation of the integrity of the epidermal dome opens a direct gate for staphylococcal infection, which quickly translates the superficial inflammation into a purulent-necrotic process with the risk of damage to the calcaneus.
Rules of warming up and first aid
The main principle of pre-medical care is the gradual restoration of microcirculation from the inside out. The sharp temperature contrast destroys the spasmodic capillaries, which do not have time to expand to accept the sharply increased volume of arterial blood.
Strict restrictions must be observed to prevent vascular death.:
- do not rub frostbitten heels with snow, wool cloth or alcohol solutions;
- do not put your feet in a basin of hot water and do not apply hot water bottles;
- do not apply greasy ointments on cold skin, as they block heat exchange.
The victim is placed in a warm room and a heat-insulating bandage is applied to the feet. A layer of sterile bandage alternates with a thick layer of cotton wool and is fixed with an elastic cloth. This protection works on the principle of a thermos flask, allowing the heels to warm up solely due to internal blood flow.
Plentiful warm drink in the form of sweet tea or compote accelerates the systemic warming of the body. Nonsteroidal anti-inflammatory drugs in standard dosages are used to relieve pain that occurs during the restoration of innervation.
Drug therapy and healing
Treatment of superficial frostbite is aimed at improving tissue trophism and preventing infection. Dexpanthenol-based preparations are applied to warmed and dry skin. They stimulate basal cell division and accelerate the epithelialization of damaged areas.
To restore the destroyed capillaries, vascular surgeons prescribe ointments that improve the rheological properties of blood. The local use of anticoagulants prevents the formation of microthrombi in the vascular bed of the heel, providing the tissues with oxygen and nutrients necessary for regeneration.
During the active healing phase, the skin of the heels becomes dry and prone to cracking. At this stage, lipid-reducing creams and ointments with vitamin A are introduced into therapy. Wearing hard shoes is excluded until the stratum corneum is fully restored, so as not to provoke repeated traumatization of the young epidermis. https://1winind.in/1win-app/
