Rationale and methodology for frostbite gymnastics

Cold often has local striking effect on tissues, causing frostbite some areas of the body. However, under the influence of low temperature environment may occur and General cooling (freezing), accompanied by a progressive drop in body temperature. Effect of low temperature does not cause the immediate death of tissue, but creates conditions that hamper the normal functioning of the organism. Infringement of physiological processes tissue begins at the temperature from +35 to +30 degrees, and at a temperature below +25 degrees death occurs. Thus, cold injury can occur not only at negative ambient temperatures.
In wartime, cold injury, according to the materials of different authors vary from 2 to 16% of all sanitary losses. Frostbite can be mass in time of peace, when, for example, people are deprived of shelter and protection from the cold by natural disasters. Possible frostbite and during class winter sports (due to irrational service, for example).
The leading role in the development of local tissue damage for frostbite belongs to the disorder of blood circulation and subsequent tissue hypoxia.
One of the features of cold injury is the hidden nature of the damage occurring in tissues during low temperature (latent period, or the period of General and local tissue hypothermia). Only after warming when temperature conditions are created for normal functioning of the body, you can recognize these injuries.
By the severity of local disorders in diseased tissue allocate 4 degree frostbite:
I degree - reduction of the tissue temperature slightly and briefly, frostbitten area after warming blue and swollen, sometimes becomes a marble color;
II degree - to the affected areas occur blisters filled with clear fluid; affected only the epidermis, germ layer of skin remains almost intact;
III degree - necrosis of the skin at all its depth;
IV degree - affected bones and joints of the extremities. Treatment of frostbite I and II degrees, if it is timely, ends with the complete restoration of normal skin. The outcome of the III degree frostbite is the formation of scar tissue. Frostbite IV degree leads to amputation within the affected bone.
Lost in freezing the skin is restored through free skin plastics. Frostbite can be accompanied by complications and diseases, such as acute suppurative infectious complications (abscess, lymphadenitis, septic arthritis, osteomyelitis, and so on), neuritis (neuritis cooling), arthritis, endarteritis, ulcers limbs, gangrene , etc.
For frostbite may cause various disorders of sensitivity, vegetative disorders (cyanosis, rash skin of the hands and feet and so on). The viability of the affected cold tissues decreases, which worsens the conditions of healing skin grafts in surgical treatment.
Treatment of frostbite include restoring the impaired circulation in the affected areas, stopping the spread of infection, the acceleration of the rejection of necrotic tissues, amputation, and free skin autoplastika (for frostbite III and IV degrees).
The technique of medical physical culture for frostbite is based on the same principles as for burns. It depends on the degree square, localization frostbite. With deep frostbite develops persistent spasm of the blood vessels, leading to tissue hypoxia. Therefore, therapeutic physical culture should be applied in the earliest periods-on 2 - 5th day after the injury. The implementation of restorative and special exercises (flexion, extension, extension, lead upper and lower limbs) contributes to the improvement of General and local blood circulation, reduce the effects of hypoxia. Exercise for frostbite and General cooling are not only effective treatment, but also reliable preventive against contractures of different origin.
The overall prognosis for frostbite more favourable than in burn disease. However, it should be noted that for frostbite III and IV degrees in a significant number of patients have to be amputated limb. In this regard, the most important task of medical physical culture is the preparation of patients to the use of the prosthesis by the method used in the amputation of limbs.
In people who have had a General cooling, for a long time there are disorders of the nervous and cardiovascular systems, infringement of function of the gastrointestinal tract, pneumonia and other complications. Therefore the methodology of medical physical culture should be built taking into account of these features, and in accordance with the methodology used for the diseases.