Frostbite: Pathogenesis and treatment

Frostbite, once almost exclusively a military problem, is becoming more pre valent among the general population and should now be considered to be with in the scope of the civilian physician's practice. Studies into the epidemi ology of civilian frostbite have identified several risk factors that may a id the clinician in the diagnosis and management of cold injuries. Research into the pathophysiology has revealed marked similarities in inflammatory processes to those seen in thermal burns and ischemia/reperfusion injury. E vidence of the role of thromboxanes and prostaglandins has resulted in more active approaches to the medical treatment of frostbite wounds. Although t he surgical management of frostbite involves delayed debridement 1 to 3 mon ths after demarcation, recent improvements in radiologic assessment of tiss ue viability have led to the possibility of earlier surgical intervention, In addition, several adjunctive therapies, including vasodilators, thrombol ysis, hyperbaric oxygen, and sympathectomy, are discussed.