What are the recommendations for managing freezer burn?

Management of Freezer Burn

For freezer burn, the recommended management is to protect the affected tissue, apply bulky dressings, and consider NSAIDs such as ibuprofen to decrease inflammation and further tissue damage. 1

Understanding Freezer Burn

Freezer burn is a type of cold injury that occurs when frozen food or tissue is exposed to air, causing dehydration and oxidation. While not as severe as frostbite, it shares similar mechanisms of tissue damage:

• Ice crystals form in cells, potentially destroying cell membrane integrity
• Tissue becomes dehydrated and oxidized
• Affected areas may appear discolored, dried out, or leathery

Management Protocol

Immediate Care

• Remove any constricting items such as jewelry or tight clothing 1
• Protect the affected tissue from further mechanical damage 1
• Do not rub or massage the affected area as this can cause additional tissue damage

Rewarming (if tissue is frozen)

• Use warm water immersion at 37°C to 40°C (98.6°F-104.0°F) for rapid rewarming 1
• Avoid using very hot water or direct heat sources
• Do not use ice water, as this can increase tissue damage 2, 3
• Continue rewarming until the affected area becomes soft and sensation returns

Post-Thaw Care

• Apply bulky dressings to provide protection and insulation 1
• Keep dressings clean and dry to reduce infection risk 1
• Use loose, circumferential wrapping to allow for swelling 1
• Consider NSAIDs such as ibuprofen to decrease inflammation (though direct clinical evidence is limited) 1

Important Cautions

• Strictly avoid refreezing of thawed tissue as this causes additional damage 1
• Do not begin rewarming if there's a risk of refreezing 1
• Protect thawed tissues from pressure, which can lead to pressure sores and necrosis 1
• Monitor for signs of infection in thawed tissues 4

When to Seek Medical Attention

Seek immediate medical care if:

• The affected area shows signs of infection (increased redness, warmth, swelling, discharge)
• There is severe pain that doesn't respond to over-the-counter pain medication
• The affected area involves large portions of hands, feet, face, or other sensitive areas
• There are signs of deeper tissue damage or necrosis

Special Considerations

• For children, monitor for signs of hypothermia during rewarming procedures 1
• If the freezer burn is accompanied by hypothermia, prioritize rewarming the core before extremities 1
• Frostbitten hands and feet should not be used for climbing or walking whenever possible 1

The American Heart Association and American Red Cross guidelines emphasize that protecting frozen and thawed tissues is crucial, as they are extremely vulnerable to further injury and infection 1. While most freezer burns are minor and heal with basic care, deeper cold injuries may require specialized medical attention.