Retrospective study of 70 cases of severe frostbite lesions: a proposed new classification scheme

Cauchy, Emmanuel; Chetaille, Eric; Marchand, Vincent; Marsigny, Bernard

doi:10.1580/1080-6032(2001)012[0248:rsocos]2.0.co;2

Cited by 112 publications

(74 citation statements)

References 14 publications

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“…Cauchy et al 15 recognised that frostbite classifications were based on retrospective diagnoses and could not predict the extent of final tissue loss and prognosis for the patient. The 3–6 week waiting period often necessary to determine the severity of the lesion and resultant need for amputation often causes mental anguish for patients.…”

Section: Clinical Presentation and Classificationmentioning

confidence: 99%

Cold damage to the extremities: frostbite and non-freezing cold injuries

Imray

Dhillon

2009

Postgraduate Medical Journal

194

164

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The treatment of cold injuries to the periphery has advanced substantially in the last 10 years and optimal outcomes are only likely to be achieved if a multidisciplinary team uses the full range of diagnostic and treatment modalities that are now available. The internet and satellite phones with digital images allow immediate access by patients from remote geographical locations to hospital based specialists who can assess cold injuries and advise on early field care. The severity of frostbite injuries can now be assessed with triple phase bone scanning, allowing early prediction of likely subsequent tissue loss. Early hyperbaric oxygen therapy appears to improve outcome and the use of intravenous drugs such as synthetic prostaglandin analogues infusions and tissue plasminogen activator have been shown to reduce amputation rates. In non-freezing cold injuries the early administration of analgesia, the avoidance of secondary exposure, and the use of infrared thermography to assess the injuries are among newer approaches being introduced.

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Section: Clinical Presentation and Classificationmentioning

confidence: 99%

Cold damage to the extremities: frostbite and non-freezing cold injuries

Imray

Dhillon

2009

Postgraduate Medical Journal

194

164

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“…Cauchy et al [14] proposed a predictive classification system that is based on the topography of the lesion(s) and early 99 technetium bone scanning. Using these techniques it is now possible accurately to predict the likely outcome as early as two days ( [13] by helicopter from mountainside to hospital is often possible in Europe and North America hospital and eliminates the first phase.…”

Section: Classificationmentioning

confidence: 99%

A Clinical Review of the Management of Frostbite

Davis

Dhillon

et al. 2011

J R Army Med Corps

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Frostbite is a thermal injury that can occur when temperatures drop low enough for tissue to freeze. On rewarming the tissues, an inflammatory process develops which is often associated with tissue loss. The extent of the tissue loss reflects the severity of the cold exposure and includes factors such as temperature, duration, wind chill, altitude, and systemic hypothermia. This review discusses the epidemiology, the pathophysiological processes involved, and the clinical management of frostbite injuries. Practical advice is given on both the field and hospital management and how to seek expert advice from remote situations. The review also discusses newer developments in frostbite treatment such as intra-vascular thrombolysis and adjunctive treatments such as the use of intravenous vasodilators.

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“…Multiphase bone scintigraphy is indicated in patients who present with second-, third-, or fourth-degree frostbite injuries (2,15). The scan should be performed 2-4 days after the original injury, or after angiography is completed in patients who undergo intra-arterial thrombolysis (34)(35)(36)(37)(38).…”

Section: Radiographicsrsnaorgmentioning

confidence: 99%

“…Clear demarcation of the level of tissue loss occurs at SPECT/CT well before its appearance at physical examination (Fig 10). This enables earlier surgical planning and intervention and in turn may contribute to lower risk for superinfection or sepsis, shorter hospitalization, and earlier rehabilitation (15,34). Use of SPECT/CT during initial multiphase bone scintigraphy may minimize the necessity of performing follow-up examinations because fewer ambiguities arise regarding the status of affected areas.…”

Section: Spect/ctmentioning

confidence: 99%