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Classification of frostbite injuries

Authoring team

Frostbite injuries can be classified into grades 1 to 4 depending on the clinical presentation after rewarming (1,2)

  • grades 1 to 2 comprising superficial frostbite injuries
    • grade 1, cyanosis is absent, andthe risk of amputation is minimal
    • grade 2 frostbite presents with cyanosis on the distal phalanx of fingers or toes, and isassociated with a moderate risk of amputation
  • grades 3 to 4 deep frostbite injuries
    • grade 3 frostbite injury
      • cyanosis upto the metacarpophalangeal joint (MCP; base of the fingers) or metatarsophalangeal joint (MTP; middle of the foot)
      • bears a high risk of amputation
    • grade 4 injuries
      • cyanosis is seen proximal to the MCP or MTP joint
      • the risk of amputation is almost 100% (2)

Reference:

  • Handford C, Buxton P, Russell K, Imray CE, McIntosh SE, Freer L,et al. Frostbite: a practical approach to hospital management.Extreme Physiology & Medicine 2014;3:7
  • Cauchy E, Chetaille E, Marchand V, Marsigny B. Retrospective study of 70 cases of severe frostbite lesions: a proposed new classification scheme. Wilderness & Environmental Medicine 2001;12(4):248-55

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