Table 4 A management pathway for cutaneous cold induced burns
From: Cold burn injuries in the UK: the 11-year experience of a tertiary burns centre
Intervention (level of evidence) | Reference |
|---|---|
1. First aid with warm water 37–39 °C for 30 min–1 h. (1B) | |
2. Analgesia including ibuprofen (prostaglandin inhibitor) unless contraindicated. (2C) | [17] |
3. Escharotomy ± fasciotomy if clinical suspicion of compartment syndrome. (1C) | |
4. De-roofing of blisters (under general anaesthetic if indicated). (2C) | [16] |
5. Aloe vera (antithromboxane) gel topically. (2C) | [10] |
6. Elevation, splinting and barrier dressings. (2C) | [10] |
7. Antibiotics if evidence of infection. (1C) | [22] |
8. In severe frostbite wounds to extremities or digits, thrombolytic/prostacyclin therapy is to be considered. (1B) | |
9. Resurfacing of wound if indicated with skin graft ± skin substitute. (2C) | [23] |