title: Immediate treatment of frostbite using rapid rewarming in tea decoction followed by combined therapy of pentoxifylline, aspirin & vitamin C.
abstract: OBJECTIVE
  Frostbite, the severest form of cold injury is a serious medical problem for our Armed Forces operating in the snow bound areas at high altitude. Effects of treatment by rapid rewarming in tea decoction followed by combined therapy of pentoxifylline, aspirin and vitamin C were evaluated in amelioration of tissue damage due to experimentally induced frostbite in rats.
  
  
  METHODS
  Experiments were conducted in 2 groups (25 each) of albino rats (control i.e., untreated and experimental i.e., treated). Frostbite was produced experimentally in all the animals by exposing one of the hind limbs at -12 +/- 1 degree C with wind flow 25-30 lit/min for 30 min in a freezing-machine, with simultaneous recordings of rectal and ambient temperatures. The degree of tissue damage was assessed after 10 days. Following cold exposure, neither external thawing nor any medication was given to the animals of the control group; while the exposed limb of the experimental animals was rewarmed in tea decoction maintained at 37-39 degrees C for 30 min immediately after cold exposure, with simultaneous oral ingestion of warm tea decoction. These animals were also given pentoxifylline (40 mg/kg), aspirin (5 mg/kg) and vitamin C (50 mg/kg) twice daily orally for the next 7 days.
  
  
  RESULTS
  In the control group, 68 per cent animals suffered from severe (56%) to very severe (12%) frostbite, while the remaining 32 per cent had moderate frostbite. No animals of this group could escape injury or suffered anything less than moderate frostbite; whereas 52 per cent of experimental animals escaped injury (no frostbite) and 32 and 16 per cent suffered only with primary and moderate degree of injury, respectively. None from this group suffered from severe or very severe frostbite.
  
  
  CONCLUSIONS
  It is evident from the study that this combined therapy resulted in significant improvement in the degree of tissue preservation and proved to be highly beneficial as an immediate treatment of frostbite in rats. The combined pharmacological properties of these drugs might have altered the haemorrheologic status of blood and produced curative beneficial effect in improving tissue survival. Clinical studies are required for confirmation of these beneficial effects in humans, which has already been taken up.
authors.affiliation: Cold Physiology Department, Defence Institute of Physiology & Allied Sciences, Defence Research & Development Organization, Lucknow Road, Timarpur, Delhi 110054, India.
authors.forename: S S
authors.initials: SS
authors.lastname: Purkayastha
authors.forename: G
authors.initials: G
authors.lastname: Bhaumik
authors.forename: S K S
authors.initials: SK
authors.lastname: Chauhan
authors.forename: P K
authors.initials: PK
authors.lastname: Banerjee
authors.forename: W
authors.initials: W
authors.lastname: Selvamurthy
mesh_terms: D000818:Animals; D001205:Ascorbic Acid / Q000627:therapeutic use*; D001241:Aspirin / Q000627:therapeutic use*; D016861:Cyclooxygenase Inhibitors / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D016166:Free Radical Scavengers / Q000627:therapeutic use*; D005627:Frostbite / Q000628:therapy*; D006401:Hematologic Agents / Q000627:therapeutic use*; D006358:Hot Temperature / Q000627:therapeutic use*; D008297:Male; D010431:Pentoxifylline / Q000627:therapeutic use*; D051381:Rats; D017207:Rats, Sprague-Dawley; D012996:Solutions; D013662:Tea; D013997:Time Factors
chemical_list: D016861:Cyclooxygenase Inhibitors; D016166:Free Radical Scavengers; D006401:Hematologic Agents; D012996:Solutions; D013662:Tea; D001205:Ascorbic Acid; D001241:Aspirin; D010431:Pentoxifylline