1/3. Hyperbaric oxygen treatment in deep frostbite of both hands in a boy.An 11-year-old boy in good general health conditions suffered deep frostbite on six fingers while he was working without gloves as a beater during a hunt in poland at an outdoor temperature of -32 degrees C over a 4 h-period. Three days later he was first seen by a physician who planned to amputate the affected fingers. The patient was transferred by his family to our University Hospital in Aachen, germany. We found third degree frostbite on four fingers of the right and on two fingers of the left hand. Because of the late beginning of the therapy, the patient was treated by HBO(2) according to the Marx-schema for problem wounds (2,4 bar, total time at depth: 90 min, alternations of 100% O(2) and air breathing). HBO(2)-treatment was repeated daily for 14 days. No adverse events were recorded during the course of therapy. A total recovery of the severe frostbite was observed after 14 days of HBO(2)-treatment. Twenty-eight months after the injury the patient reports fully regained sensibility and no pain. The plain X-ray after this period showed no premature closure of the epiphyses or sclerosis of the metaphyses. Conclusions: Because of the low risk associated with HBO(2), and its potential therapeutic efficiency, HBO(2) should be recommended as adjunct therapy in the treatment of deep frostbite.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
2/3. frostbite in a mountaineer.Cold injury is an objective danger in mountain climbing as well as in many outdoor sports. With increasing number of people practising so-called extreme tourisms physicians can be confronted with frostbite. Thus we present a case of frostbite in a 35 year-old female mountaineer. She took part at a demanding high alpine trekking tour in the Himalayan-area requesting well trained mountaineers experienced in ice- and securing-techniques and good physical condition. At day 12, when the group reached the top of the Parchamo (nepal, 6273 m), she developed frostbite at all toes leading to amputation finally. risk factors, prognosis and options for initial treatment are discussed.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |
3/3. frostbite: an overview with case presentations.Much of the interest in frostbite has arisen from various military experiences including the korean war, world war ii, and Napolean's battles in russia and poland. Historically frostbite has been not only a military problem, but also a problem in high-altitude climbers and the more recently investigated homeless population. However, the physician should not disregard frostbite as only victimizing the poor and indigent. Anyone who is exposed to harsh winter conditions over a long period of time can suffer from frostbite. Many milder cases of frostbite presented to Cook County Hospital in chicago were simply due to prolonged winter exposure when a motorist's care broke down. The authors present a review of the variants, pathophysiology, classifications, predisposing factors, and treatment of frostbite. Five cases of frostbite will also be presented from Cook County Hospital in chicago, IL.- - - - - - - - - - ranking = 1keywords = physician (Clic here for more details about this article) |