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PubMed2003

[Early diagnosis and prognosis of severity in frostbite of the extremities].

Early diagnosis of the depth of extremity frostbite is of little effect without additional means of examination (from 39.9% to 43.6% of correct findings at the pre- and intrahospital stages of medical care). It can be improved (up to 61.5% of verified answers) when using the method of calculation of cold loading. The combination of distant infrared thermography (DIRT) and contact thermometry allows to make the verification as great as 78.3%. If the task of the diagnosis is only to determine the form of frostbite (superficial or profound), using the temperature criteria (by the data of contact thermometry) and thermographic algorithms (on the basis of the data of DIRT) is shown to improve diagnosis up to 88.4%-92.4% of correct answers on the hands and up to 82.5%-86.8% on the feet.

Frostbite↗

PubMed2003

[Increased cortisol levels, frostbite and effects on the muscles and skeleton during extreme polar conditions].

BACKGROUND: We wanted to record physiological changes, injuries and illnesses during a long sledge expedition in North Canada. MATERIAL AND METHODS: The expedition consisted of four men aged 41 to 50, and 16 polar dogs. Measurements of cortisol in saliva were performed before, during and after the expedition. Frostbites and other injuries were registered continuously. Body weight and muscle, fat and bone mass were measured by dual X-ray absorptiometry scanning, and strength and endurance of shoulders, knees and back were tested. The group encountered extreme frost (-30 to -42 degrees C day temperature), wind, unexpected amounts of pack ice, and poorly motivated dogs. RESULTS AND INTERPRETATION: The participants showed increased free cortisol levels during their stay on the ice, probably because of increased mental stress. Three got first degree and two second-degree frostbites, but the affected areas were normal on vascular examination five months later. All members increased their muscle mass, but muscle strength and endurance remained unchanged.

Absorptiometry, Photon↗

PubMed1992

[Mountain frostbite. A new approach to early prognosis. A study of 1,267 cases].

Regarding an important series of mountain frostbite (1,267 cas), the authors try to explain the physiopathological mechanism. They expose the different methods that make possible nowadays an early prognosis. They set forth the treatment that seems still limited to save what can be spared; and this is valid for severe frostbite, the only ones to put problems. The quick warming up is the keystone of the treatment.

Adult↗

PubMedDate not supplied

Nursing a patient with frostbite.

Frostbite is a condition that is associated with people living in countries with an extremely cold climate. However, it can affect people in the UK who are involved in winter sports, and is also associated with the homeless, people with a psychiatric illness, and those who misuse drugs and alcohol. Angela Davies describes the assessment and management of a patient with frostbite and identifies the challenges of managing these complex tissue injuries

Adult↗

PubMed1991

[Mountain frostbite (apropos of 1260 recorded cases)].

Based on an important statistic of mountain frostbite (1260 cases), the authors try to explain the underlying physiopathological mechanism which remains largely unknown. An early prognosis may nowadays be improved by several diagnostic tools whose efficiency is reviewed. Difficult problems arise with severe frostbite only. In those cases, the treatment as such seems still limited to saving what has been spared. In any case, a quick warming up is the keystone of the treatment.

Combined Modality Therapy↗

PubMed1990

[Characteristics of the sequelae to frostbite of the extremities].

At the burn centre in Donetsk, from 1979 to 1988, 236 sufferers with a III-IV degree frostbite of the extremities were treated. Operated on were 189 patients, who underwent necrectomy, amputation of the extremity and different types of skin plasty. Of these patients, 49.8% were recognized as invalids. After 1-10 years, all the patients after a III-IV degree frostbite of the extremities make complaints, require different types of treatment, 38.9%--the operative one. For timely and qualitative rehabilitation of this category of the sufferers, their prophylactic medical examination is necessary.

Extremities↗

PubMed1989

Frostbite injuries during winter maneuvers: a long-term disability.

Frostbite injuries are a common problem associated with military operations in cold environments. Long-term disability can result. A follow-up study of 40 patients with documented frostbite injuries reveals that 65% are still having symptoms attributable to their initial injuries. This appears to be a higher percentage than most studies would suggest.

Acute Disease↗

PubMed1989

Frostbite injuries of the hand.

Injury from frostbite has had a profound effect on developing civilizations and continues to affect modern day humans. Rational therapy and future research for frostbite must be based on a comprehensive understanding of the physiology of tissue freezing and healing. Therapy directed toward maximizing the likelihood of secondary healing is divided into field, emergency department, and nonacute management.

Child↗

PubMed1988

[Treatment of deep burns and frostbite of the hand and fingers].

Under observation there were 186 patients with thermal burns and 59 patients with frostbites of hands and fingers. Free skin plasty with a splitted autotransplant was used in 29 patients. Plasty on a temporary feeding pedicle was used in 39 patients. Better results were obtained in remote terms in patients after non-free dermoplasty. In patients with burns and frostbites of the IVth degree no labour rehabilitation was achieved.

Adolescent↗

PubMed1988

[Arolla index. A study of 88 cases of frostbite during a high-mountain race].

A sudden change in meteorological conditions provoked frostbite in 88 competitors in a high mountain race, 31 lesions being of 1st degree, 38 of superficial 2nd degree, 12 of deep 2nd degree and 7 of 3rd degree severity. Etiology, localization, treatment and outcome of the lesions are discussed. The precise knowledge of weather conditions and position of patrols over the length of the course enabled intensity of cold exposure to be related to onset of frostbite: an index termed "Arolla" is proposed which in contrast to the windchill index allows for exposure time. Distribution of patrols using standardized equipment allowed determination of importance of individual factors: the latter is considerable. Medical care in high mountain situations is commented upon.

Adult↗

PubMed1986

Increased lethality of endotoxemia in murine frostbite.

Because frostbite (FB) is associated with increased intravascular coagulability, it is reasonable to assume that endotoxin, by enhancing platelet aggregation, will adversely affect FB. Swiss mice (25 +/- 2 g) were anesthetized, and the tails of the animals totally immersed in a freezing solution of equal volumes of ethylene glycol and water (-18 C) for 8 min. The tails were then thawed at room temperature (24 C). Half an hour after removal from the freezing solution, the animals were given either (Group A) 0.1 cc saline I.P. or (Group B) 0.1 mg E. coli endotoxin (055:B5; 1/3 LD50 dose) in 0.1 cc saline IP. A third group (Group C), was given the same dose of endotoxin but was not subjected to frostbite. Survivals in each group at 2 weeks were as follows: (A) 14/14 (100%), (B) 4/20 (20%), (C) 13/14 (93%). Using Fisher's exact test, A versus B P less than .001; B versus C P less than .001; A versus C NS. The data presented here emphasize the increased lethality of endotoxemia in murine FB.

Animals↗

PubMed1987

[The condition of systemic and organ blood circulation in patients with frostbite].

This paper is based on results obtained from 130 experiments and from clinical observation of 98 patients with different degrees of frostbite. Systemic and organic blood circulation was investigated by means of electrocardiography, phonocardiography, rheocardiography, rheovasography, and oscillography for the purpose of establishing arterial pressure and amount of circulating blood. Observations made soon after the event of frostbite included weakening of cardiac contraction with drop in systolic discharge, vasoconstriction of affected extremities, primarily in the system of microcirculation, and quantitative reduction of circulating blood.

Animals↗

PubMedDate not supplied

Frostbite arthritis.

We report a case of unilateral frostbite arthritis in a 58-year-old male. Clinical and radiological changes mimicked those of erosive osteoarthritis. Patients with this presentation should be carefully questioned for a history of exposure to cold, and frostbite arthritis should be considered in the differential diagnosis.

Acute Disease↗

PubMedDate not supplied

[Treatment of frostbites. Analysis of results in twenty patients with buflomedil chlorhydrate (author's transl)].

Twenty cases of mountain frostbites of various degrees are presented, showing that buflomedil hydrochloride allows an improvement of the usual treatment of frostbites. Two protocols were used: 1) in 8 patients, after the usual treatment (bath at 38 degrees C, dextran perfusion, heparintherapy, antibiotherapy), buflomedil hydrochlorhydrate was administered by perfusion of 8 vials/day, during 10 days; 2) in 12 patients, buflomedil was injected directly by intravenous route on their arrival in the Emergency room. When the injection is given early, a potentiation of the effects of the warm bath is observed, and in two cases, this therapy has perhaps allowed to avoid the amputation.

Adult↗

PubMed1984

Frostbite.

Frostbite can cause loss of life and limbs. Proper treatment and follow-up care are essential in reducing morbidity and mortality. Management of the frostbite patient consists of three stages. Initial care includes protection of the extremity from trauma or partial thawing. The second stage consists of rapid rewarming in a whirlpool bath containing hot water, with continued protection of the tissues. The third stage is long-term care of the affected body parts.

Adolescent↗

PubMed1984

Detrimental effects of ethanol on murine frostbite.

Many references have been made concerning the adverse effects of ethanol in human frostbite. The lack of experimental evidence to support this belief prompted the authors to undertake this investigation. Nineteen Swiss-Webster mice (25 +/- 2 gm) were given intraperitoneal injections of 0.2 cm3 of 50 per cent ethanol (group A) or 0.2 cm3 saline (group B). Thirty minutes later, the animals were anesthetized with pentobarbital (group A 30 mg/kg; group B 50 mg/kg). Lower barbiturate dose was used in group A because of the synergistic central nervous system depressant effect when combined with alcohol. Tail lengths of all animals were measured. The tails were immersed in a 50 per cent ethylene glycol solution (-18 C) for 6 min and then thawed at room temperature (24 C). At 24 hrs, tail circulation was assessed by length of tail perfused with the vital dye alphazurine 2 gm given intraperitoneally. Mortality to 14 days was recorded. All animals survived the initial anesthetic and/or alcohol administration. Group A had a statistically significant (P less than 0.001 Students t test) decrease in length of tail perfused compared with group B at 24 hours (0.98 +/- 0.19 cm versus 2.58 +/- 0.23 cm). Fourteen day survival was 10 per cent in group A compared with 89 per cent in group B (P less than 0.001, chi-square test). We conclude that ethanol has significant adverse effects on tissue perfusion and mortality associated with severe murine frostbite.

Alcohol Drinking↗

PubMed1978

Effect of rewarming at various water bath temperatures in experimental frostbite.

Studies have been conducted on 72 rats to determine the most suitable temperature at which rapid rewarming should be done as an immediate treatment for frostbite. Animals were put in a harness containing arrangements for warming the body. Their hind limbs were left out of the harness. They were then exposed to -15 degrees +/- 1 degrees C in a deep freeze for 60 min, during which paw temperature was recorded every 5 min. After this, the animals were taken out, the left hind limb was rapidly rewarmed in a water bath maintained at 35 degrees, 37 degrees, 39 degrees, 41 degrees, 43 degrees, or 45 degrees C for different batches and the right hind limb was left free for slow rewarming at room temperature (27 degrees -29 degrees C). The severity of cold injury in the two limbs was compared. The paw temperature showed a drop on cold exposure, followed by a rapid rise and then a second fall. The degree of injury was related to the duration of exposure after the rise in the paw temperature. The rapid rewarming was effective only at water bath temperature of 37 degrees-39 degrees C and was harmful at 45 degrees C. This shows that rewarming at about body temperature is most effective as immediate treatment for frostbite.

Animals↗

PubMed1982

Electric burns and frostbite: patterns of vascular injury.

This pattern of vascular damage after electrical burn or frostbite injury was studied angiographically in rabbits. Frostbite caused a progressive increase in the arterial and venous thrombosis after initial spasm as observed from 15 minutes to 48 hours. The electric injury caused serious vascular damage to be evident at 15 minutes with a slight progression continuing to 48 hours. Anticoagulation and a medical sympathectomy delayed the appearance of vascular injury but did not affect the ultimate vascular or tissue damage.

Angiography↗