• What happens after frostbite?

Authors: Malcolm Davidson, Alex Poole, Caitlin Champion

In the weeks that follow initial frostbite treatment, care is focused on avoiding infection, and supporting healing. Low grade (1-2) injuries are expected to heal with topical therapy and water cleansing alone. Higher grade (3-4) frostbite injuries are at greater risk of complications such as infection; for this reason, closer monitoring by wound care nurses and follow up with a surgeon is recommended.

What should I watch for?

Monitoring for signs of infection including odor, wet and/or discoloured tissue or purulent drainage is important and any concerns should be communicated to a health care provider.

Will I get an amputation?

Amputation most commonly affects individuals with higher grade (Grade 3-4) injuries. The decision to amputate is influenced by whether or not infection is present, the location and amount of affected tissue, and a person’s overall function and health. Regular follow up with a surgical specialist is important in making amputation decisions that are right for you and supporting your recovery. 

What can I do to help with healing?

Dressings with a combination non-adhesive layer with dry bulky gauze overtop for protection is recommended, with the goal of encouraging healthy tissue recovery. Daily dressing changes are recommended for the first week, then every 3-4 days for several weeks (2-3). Topical aloe vera can be applied to the wound for the first five days of injury every six hours or so, and then at daily dressing changes after (4).

Keeping the limb elevated in the first few days to weeks following injury can help minimize swelling. Gentle early mobilization may be helpful. However, when there is severe frostbite with persistent decreased sensation caution is required to avoid further injury. Your health care team including doctors, wound care nurses, physiotherapists, occupational therapists and social workers can help build a recovery plan that is right for you.

What are the long-term effects of frostbite?

Long-term complications of frostbite can include cold hypersensitivity of the affected areas, numbness, loss of function and chronic pain (5). Future skin breakdown, infection, and healing issues are also more common in frostbite affected areas due to changes in blood supply (6-10).

What supports are available to manage long-term effects of frostbite?

Managing frostbite impacts over the long term includes pain control, optimizing function, and preventing re-injury. Supportive well-fitting footwear is recommended to minimize future injury with frostbite on the feet, including custom orthotics. Frostbite arthropathy can happen in hands and feet, and can show up as pain and loss of joint mobility, similar to arthritis (5). Ongoing relationships with health care providers including your primary care provider and other health professionals (i.e. - Physiotherapy, Occupational Therapy, Nursing Wound Specialists, Social Workers, etc.) are helpful in supporting your recovery and quality of life over the long term. For more information, see About CFCN.