Frostbite in the prairies: a 12-year review

A 12-year retrospective review of inpatient frostbite injury was undertaken in three tertiary hospitals serving a northern prairie population of 650,000. In the 125 patients identified, the mean age was 41 years, with a range of 3 to 90 years. Predisposing factors were alcohol consumption (46 percent), psychiatric illness (17 percent), vehicular trauma (19 percent), vehicular failure (15 percent), and drug use (4 percent). Profound hypothermia with a core temperature less than 32 degrees C was present in 12 percent. Anatomic distribution was 19 percent upper extremity, 47 percent lower extremity, 31 percent combined upper and lower extremity, and 3 percent facial or trunk only. Factors correlating with amputation of parts (p < 0.05) were duration of exposure, lack of proper attire, remote site of injury, presence of wound infection, and delay in seeking treatment. Prophylactic systemic antibiotics did not decrease the incidence of wound infection. Comparison with nine other civilian series revealed striking similarities in the patient populations.