It is currently believed that vasospasm and thrombosis play an important role in the mechanism of tissue injury produced by exposure to cold. For this reason, within the last decade sympathectomy and anti coagulant therapy have been advocated as adjuncts in the treatment of frostbite and immersion foot (20,21). We are of the opinion that sympathectomy is of value in the treatment of sequelae from these lesions. It is known that causalgia, skin ulcerations, and other late after effects can be ameliorated by this and related procedures. However, in the acute stage of frostbite, the value of sympathetic interruption with subsequent relief of vasospasm has not been established. We therefore designed an experiment which we hoped would shed light on this point, and have studied the effects of sympathetic block using tetraethylammonium chloride' in experimental frostbite during the acute stage. This communication concerns itself with an account of this study.Acheson and Moe (1) have established that TEAC in adequate dosage is capable of producing autonomic blockade in the rabbit. A similar effect has also been demonstrated in man by Coller, Campbell, Berry and associates (3, 4, 5). Because of the relative ease with which the rabbit can be studied experimentally, this animal was used in our study. EXPERIMENTAL METHODSThird degree frostbite was produced in thirty well-fed white, adult rabbits by immersing the right hind leg in a cooled liquid menstruum for a period of thirty minutes. The liquid was cooled using solid carbon dioxide and was kept at a temperature of -10° centigrade (±2 centigrade). This temperature and length of exposure was used to produce a uniform lesion so that the results of therapy could be more accurately evaluated.Prior to immersing the leg, the hair was removed from the extremity with an electric clipper using great care not to traumatize the skin. A barium sulfide depilatory was then applied because previous experience had shown that the presence of any hair altered the severity of the lesion. Each animal was anesthetized with intravenous nembutal using a dose of 32 mg. per kilogram of body weight. The foot and a portion of the leg, approximately 2 cm. from the tuberosity of the fifth metatarsal was exposed, as mentioned, for thirty minutes.
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