Clinical manifestations Most often affects fingers, toes, noses, and ears. Gangrene possible Treatment Initial therapy is to rewarm with other body parts or clothing. Avoid rubbing, pressure, and mechanical trauma. Thawing and refreezing is associated with more permanent tissue damage and therefore rewarming methods may need to be delayed until definitive measures are available. Rewarm with immersion in water between 40-42 degrees centigrade.
Prophylactic antibiotics are controversial.
If injury is severe, surgical consultation to direct further management. Vasodilatation agents may be helpful. Surgical Clinics of North America.