Finger and Toe Temperature Responses to Cold After Freezing Cold Injury in Elite Alpinists

Wilderness Environ Med. 2015 Sep;26(3):295-304. doi: 10.1016/j.wem.2014.12.026. Epub 2015 Mar 6.

Abstract

Objective: To assess whether previous freezing cold injuries (FCI) would affect digit skin temperatures and rewarming rates during a follow-up cold stress test protocol.

Design: Nonrandomized control trial.

Methods: Twenty elite alpinists participated; alpinists with previous FCI requiring digit amputations (injured, INJ: n = 10 total, n = 8 male) were compared with ability-matched, uninjured alpinists (control, CON: n = 10, all male). Digit skin temperature was measured using infrared thermography as an index of peripheral digit perfusion after a cold stress test, which consisted of 30 minutes of immersion in 8°C water.

Results: The INJ alpinists' injured toes were warmer (approximately 6%) than their uninjured toes immediately after cold immersion (95% CI, 0.01°C to 1.00°C; P = .05); there were no differences between the rates of rewarming of injured and uninjured toes (INJ, 0.5° ± 0.1°C/min; CON, 0.7° ± 0.3°C/min; P = .16). Although the INJ alpinists had colder injured fingers immediately after the 35°C warm bath compared with their own uninjured fingers (32.2° ± 2.0°C vs 34.5° ± 0.5°C; P = .02), there were no differences observed between the rates of rewarming of injured and uninjured fingers after cold exposure (INJ, 1.1° ± 0.2°C/min; CON, 1.3° ± 0.5°C/min; P = .22).

Conclusions: Even after FCI that requires digit amputation, there is no evidence of different tissue rates of rewarming between the injured and uninjured fingers or toes of elite alpinists.

Keywords: amputation; blood flow; frostbite; mountaineering; trauma; wilderness medicine.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cold Injury / etiology
  • Cold Injury / physiopathology*
  • Female
  • Fingers / physiopathology*
  • Freezing / adverse effects*
  • Humans
  • Male
  • Middle Aged
  • Mountaineering*
  • Non-Randomized Controlled Trials as Topic
  • Rewarming
  • Skin Temperature*
  • Temperature
  • Toes / physiopathology*
  • Young Adult