Cold injury.
The pathophysiology of true frostbite reveals that the direct injury produced during the initial freeze process has a minor contribution to the global tissue damage. However, rapid rewarming to reverse the tissue crystallization has essentially been the lone frostbite intervention for almost half a century. The major pathologic process is the progressive microvascular thrombosis following reperfusion of the ischemic limb, with the cold-damaged endothelial cells playing a central role in the outcome of these frozen tissues. Newer interventions offer the opportunity to combat this process, and this article offers a scientific approach to frostbite injuries of the upper extremities.
Mohr
Wm J
WJ
The Burn Center, Department of Trauma and General Surgery, Regions Hospital, Mail Stop 11105C, 640 Jackson Street, St. Paul, MN 55101, USA. william.j.mohr@healthpartners.com
Jenabzadeh
Kamrun
K
Ahrenholz
David H
DH
D001833:Body Temperature Regulation / Q000502:physiology; D005627:Frostbite / Q000453:epidemiology / Q000276:immunology / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D011379:Prognosis; D012039:Regional Blood Flow; D012307:Risk Factors; D012867:Skin / Q000098:blood supply; D015912:Thrombolytic Therapy; D014661:Vasoconstriction / Q000502:physiology