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Non-freezing cold injuries (NFCI) is a class of tissue damage caused by sustained exposure to low temperature without actual freezing. [1] There are several forms of NFCI, and the common names may refer to the circumstances in which they commonly occur or were first described, such as trench foot, which was named after its association with trench warfare.
Cold injury (or cold weather injury) is damage to the body from cold exposure, including hypothermia and several skin injuries. [6] Cold-related skin injuries are categorized into freezing and nonfreezing cold injuries. [5] Freezing cold injuries involve tissue damage when exposed to temperatures below freezing (less than 0 degrees Celsius).
Trench foot is damage to nerves and blood vessels that results from exposure to cold wet (non-freezing) conditions. [17] This is reversible if treated early. Pernio or chilblains are inflammation of the skin from exposure to wet, cold (non-freezing) conditions. They can appear as various types of ulcers and blisters.
Complications may include skin breakdown or infection. [1] Trench foot occurs due to prolonged exposure of the feet to cold, damp, and often unsanitary conditions. [1] Unlike frostbite, trench foot usually occurs at temperatures above freezing, [1] and can be classed as a form of non-freezing cold injury. [3] Onset can be as rapid as 10 hours. [1]
Other cold-related injuries that can be present either alone or in combination with hypothermia include: Chilblains: condition caused by repeated exposure of skin to temperatures just above freezing. The cold causes damage to small blood vessels in the skin. This damage is permanent and the redness and itching will return with additional exposure.
Nonfreezing Cold Injuries (NFCI). Exposure of the extremities in water temperatures below 12 °C (53.6 °F). Hand and Foot Temperature Limits to avoid NFCI: [48] Fully Functional 18 °C (64.4 °F) Non Freezing Cold Injury Threshold < Week. 12 °C (54 °F) approximately 3 hours. 8 °C (46.4 °F) for maximum of 30 min.
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Most injuries of this type only affect the epidermis, the outermost layer of skin. However, if contact with the aerosol is prolonged the skin will freeze further and deeper layers of tissue will be affected, causing a more serious burn that reaches the dermis, destroys nerves, and increases the risk of infection and scarring. [6]