<unk>  (congelatio in medical terminology) is a freezing, cold thermal injury, which occurs on being exposed to temperatures below the freezing point of typically −0.55°C to as high as 2°C for a sustained period of time. It is a condition characterized by the consequences in terms of functional morbidity among the panel of population that are often young, fit and healthy prior to sustaining thermal injury. Currently, the prevalence of<unk>  is increasing within the civilian population, particularly among those who partake in winter sports such as skiing, hiking, mountain and ice climbing. The outdoor activities are more accessible so the individuals with limited experience or inadequate preparation and protection are highly prone to it. Additionally, vagrancy, homelessness, industrial injury and malfunctioning or misuse of equipment using NO or CO2 have also been causative factors. Cutaneous circulation plays an important role in thermoregulation by varying blood flow through peripheral structures to maintain core body temperature for survival. In a cold environment, maximal vasoconstriction is reached in hands and feet when their temperature drops to 15° C which is followed by local protective cycles of vasodilation on persistence of freezing temperature; but leads to progressive local ischemia if further exposure continues. However, thawing restores blood flow; but induces congestion, inflammation and thrombosis in the injured endothelium which may prompt erythrocyte extravasation due to distorted vessel wall. According to the depth of the skin damage, necrosis can be deeply severe which can results in spontaneous or surgical amputation.<unk>  can present with a wide spectrum of injury ranging from complete resolution without significant sequelae to major limb amputation and its functional consequences. Timely pre-hospital and definitive hospital management are important to minimize final tissue loss and maximize functionality of the affected limb. Once in the hospital setting, a multidisciplinary approach must be utilized to achieve the best outcomes. Either intravenous iloprost or thrombolysis with rTPA should be considered in all patients presenting within 24 h of sustaining an appropriately severe injury, and if the facility is capable of appropriate administration and monitoring. The treatment should be started with an immediate action to have a maximal output. Bone scanning is helpful to ascertain deep tissue injury and response to therapy. However, surgeons should avoid rushing to an early amputation; if case managed correctly in the earlier days, significant tissue can be salvaged for the final functional outcome. Prevention with education, behavior modification, following workplace guidelines, and appropriate use of modern equipment in most adventurous tourist destinations is important to reduce<unk>  incidence. Once<unk>  injury has occurred, little can be done to reverse the changes. Hence, a great preventive care should be taken to avoid its incidence.
Frostbite
Crossbite
Abrasion
Abrasion 
LeFort fracture
Nasal fracture
Freckle
Cracker Barrel