title: Finger and Toe Temperature Responses to Cold After Freezing Cold Injury in Elite Alpinists.
abstract: OBJECTIVE
  To assess whether previous freezing cold injuries (FCI) would affect digit skin temperatures and rewarming rates during a follow-up cold stress test protocol.
  
  
  METHODS
  Nonrandomized control trial.
  
  
  METHODS
  Twenty elite alpinists participated; alpinists with previous FCI requiring digit amputations (injured, INJ: n = 10 total, n = 8 male) were compared with ability-matched, uninjured alpinists (control, CON: n = 10, all male). Digit skin temperature was measured using infrared thermography as an index of peripheral digit perfusion after a cold stress test, which consisted of 30 minutes of immersion in 8°C water.
  
  
  RESULTS
  The INJ alpinists' injured toes were warmer (approximately 6%) than their uninjured toes immediately after cold immersion (95% CI, 0.01°C to 1.00°C; P = .05); there were no differences between the rates of rewarming of injured and uninjured toes (INJ, 0.5° ± 0.1°C/min; CON, 0.7° ± 0.3°C/min; P = .16). Although the INJ alpinists had colder injured fingers immediately after the 35°C warm bath compared with their own uninjured fingers (32.2° ± 2.0°C vs 34.5° ± 0.5°C; P = .02), there were no differences observed between the rates of rewarming of injured and uninjured fingers after cold exposure (INJ, 1.1° ± 0.2°C/min; CON, 1.3° ± 0.5°C/min; P = .22).
  
  
  CONCLUSIONS
  Even after FCI that requires digit amputation, there is no evidence of different tissue rates of rewarming between the injured and uninjured fingers or toes of elite alpinists.
authors.affiliation: Environmental Physiology and Ergonomics Laboratory, Department of Automation, Biocybernetics and Robotics, Jožef Stefan Institute, Ljubljana, Slovenia (Drs Morrison and Mekjavic). Electronic address: shawnda.morrison@zrs.upr.si.
authors.forename: Shawnda A
authors.initials: SA
authors.lastname: Morrison
authors.affiliation: Department of Surgery, Hospital of the Brothers of St. John of God, St.Veit/Glan, Austria (Dr Gorjanc).
authors.forename: Jurij
authors.initials: J
authors.lastname: Gorjanc
authors.affiliation: Department of Environmental Physiology, School of Technology and Health, Royal Institute of Technology, Stockholm, Sweden (Dr Eiken).
authors.forename: Ola
authors.initials: O
authors.lastname: Eiken
authors.affiliation: Environmental Physiology and Ergonomics Laboratory, Department of Automation, Biocybernetics and Robotics, Jožef Stefan Institute, Ljubljana, Slovenia (Drs Morrison and Mekjavic).
authors.forename: Igor B
authors.initials: IB
authors.lastname: Mekjavic
mesh_terms: D000328:Adult; D000067390:Cold Injury / Q000209:etiology / Q000503:physiopathology*; D005260:Female; D005385:Fingers / Q000503:physiopathology*; D005615:Freezing / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009051:Mountaineering; D065228:Non-Randomized Controlled Trials as Topic; D017694:Rewarming; D012881:Skin Temperature; D013696:Temperature; D014034:Toes / Q000503:physiopathology*; D055815:Young Adult
keywords: amputation; blood flow; frostbite; mountaineering; trauma; wilderness medicine