Frostbite

The diverse methods of therapy are directed at the mechanisms of freezing damage to tissues and the pathophysiology of the response. To prevent tissue loss, prompt rewarming of the frozen tissue is the most important treatment--practically all else is conservative wound care. Once rewarming is complete, little more can be done to alter the course of events relative to this mechanism. However, the vascular phase of injury with its characteristic endothelial damage, platelet aggregation, and thrombosis has been the subject of intensive investigation to determine if the microcirculatory failure and vasospasm may be modified and improved by appropriate therapy. Though experiments suggest that modification is possible, little benefit has been achieved in clinical therapy, probably because the patients are treated too late after thawing. Nevertheless, this remains a good field for continued investigation.