Abstract
BACKGROUND: Tissues can adhere to cold metal surfaces, causing tissue damage upon detachment. For children, this often involves the tongue, so-called tundra tongue. This study aimed to assess the risk and extent of tongue tissue damage following adhesion to cold metal lamp posts. METHODS: Eighty-four porcine tongues were acquired shortly after slaughter. The apex and basis of each tongue were separately brought into contact with a section of a cold metal lamp post and detached gradually or rapidly. Detachment force was recorded and tongues were visually inspected for macroscopic injuries. Selected tongues were assessed histologically. Finite element simulations were conducted in COMSOL Multiphysics to model intra-tissue temperature over time. Each tongue was tested twice (apex and basis), resulting in 168 experiments. Four experiments were excluded, leaving 164 for analysis. RESULTS: Avulsion injury occurred in 89 of 164 experiments (54%) with risk increasing with the detachment force (p < 0.001). Peak tongue detachment force was associated with contact time (p < 0.001), tongue region (apex versus basis, p < 0.01), and release type (rapid versus gradual, p < 0.001). A non-linear relationship was found between metal temperature and detachment force (p < 0.01), with peak adherence at approximately -7.5 °C. Histological evaluation demonstrated intra-epidermal damage that could be rationalized with computer modelling. Nearly all experiments (92%) caused macroscopic, but not microscopic, cold injury, with risk increasing at lower metal temperatures. Computer simulations suggest that tissue damage is related to superficial tissue freezing that occurs under typical winter conditions and short exposure times. CONCLUSIONS: The tundra tongue is a complex phenomenon. Although the risk of avulsion injury is significant, our findings indicate limited damage potential under normal winter conditions and brief exposure times.