Frostbite of the upper extremities: Hot issues in diagnosis and surgical treatment (review)

Frostbite is a severe thermal injury, which characterized by tissue necrosis with a high percentage of amputations, disability of patients.

According to the databases Web of Science, Google Scholar, PubMed, E-library down to 2001-2021 the search for works related to the problem of diagnosis, treatment of frostbite of the upper extremities was made. Actual possibilities of diagnostics, the questions of classification, treatment of frostbite, including the features of plastic surgery operations used to close hand defects after excision of necrotic tissues have been analyzed.

Frostbite is more common in people with alcohol dependence, mental illness and in socially disadvantaged groups. The most informative instrumental methods of diagnosis: bone scintigraphy, magnetic resonance imaging, single-photon emission computed tomography. Thrombolytic therapy (tPA) and prostacyclin are most effective if used within the first day after tissue rewarming. With deep frostbite and late medical care surgical treatment is fundamental. Amputation and debridement are carried out after the formation of the demarcation line. To replace soft tissue defects that extend beyond the fingers, it is preferable to use fasciocutaneous flaps.

The defining moments in the treatment of deep frostbite are timely diagnosis and complex treatment. With late admission surgical treatment, including reconstructive skin plastic surgery, becomes important.