[Non-freezing cold injury in soldiers]

Non-freezing cold injury (NFCI) is an injury of the hands or feet resulting from exposure to wet conditions and temperatures just above freezing, typically found in soldiers. NFCI is due to microvascular endothelial damage, stasis and vascular occlusion. At first, the tissue is cold and anesthetic, progressing to hyperemia in 24-48 hours. Hyperemia is accompanied by an intense painful burning sensation as well as blisters, redness, and possibly, ulcerations. NFCI management raises frustration in both medical officers and commanders. Most authorities are not aware of or remain unimpressed with the severity of NFCI, nor do they realize that it produces lifelong symptomatology. The following review of the available literature attempts to clear up some issues regarding the definition, pathogenesis, symptoms and preventative measures available in NFCI, including our own experience.