What are the characteristics of fourth-degree frostbite?

Updated: Oct 13, 2020
  • Author: Bobak Zonnoor , MD; Chief Editor: Dirk M Elston, MD  more...
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Sequelae include tropic ulceration, severe cold sensitivity, and growth plate injury.

Fourth-degree frostbite has the following characteristics:

  • Involvement of muscle, bone, and tendons

  • Frozen, hard, and avascular skin and tissue underneath

  • Mottled tissue, with nonblanching cyanotic skin that eventually becomes dry, black, and mummified

  • Relatively little pain experienced on rewarming

  • Minimal-to-mild postthaw edema

Demarcation between living and nonviable tissue takes 1 month. Spontaneous amputation takes another month after demarcation.

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