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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.
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] Risk factors include overly tight boots and not moving. [4]
Preventative measures such as rotating trench positions, changing socks multiple times per day, and using whale oil on one's feet were introduced to reduce incidence of cases. [2] Cold skin injuries are still prominent in the modern era, with 1,120 cases of frostbite and 590 cases of trench foot reported in the US military from 2015-2020. [8]
First degree frostbite is superficial, surface skin damage that is usually not permanent. Early on, the primary symptom is loss of feeling in the skin. In the affected areas, the skin is numb, and possibly swollen, with a reddened border. In the weeks after injury, the skin's surface may slough off. [10] Third degree frostbite developing.
Chilblains, also known as pernio, is a medical condition in which damage occurs to capillary beds in the skin, most often in the hands or feet, when blood perfuses into the nearby tissue, resulting in redness, itching, inflammation, and possibly blisters.
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Immersion foot syndromes are a class of foot injury caused by water absorption in the outer layer of skin. [1] [2] There are different subclass names for this condition based on the temperature of the water to which the foot is exposed. These include trench foot, tropical immersion foot, and warm water immersion foot.
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. The redness and itching typically occurs on cheeks, ears, fingers, and toes. [10] Frostbite: the freezing and destruction of tissue, [11] which happens below the freezing point of water