Skin coverage in frostbite injuries: Experimental study

Delgado-Martínez, Julio; Martínez-Villén, G.; Morandeira, J. R.; Velasco, Rodrigo

doi:10.1016/j.bjps.2010.05.016

Cited by 7 publications

(5 citation statements)

References 16 publications

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“…Ideally, the animal model used for screening would be reliable and affordable in such degrees to allow quantification of the rate of wound healing or amount of corpus tissue lost as a result of freezing tissue. Previous animal models for frostbite include hairless mouse ears, 8,11 depilated mouse ears, 12,13 rabbit ears, 6 ,9,14–17 dog paws, 18,19 rabbit feet, 20 rabbit legs, 21 golden hamster cheek pouch, 22,23 rabbit mesenteries, 24 mouse tails, 25 mouse leg muscle, 26 and rat hind limbs. 27 This article describes a novel model of frostbite wounding utilizing ceramic magnets to freeze dorsal dermal tissue, which observes a normal progression of wound healing through granulation and reepithelialization.…”

Section: Discussionmentioning

confidence: 99%

A Novel Mouse Model for Frostbite Injury

Auerbach

Galvez

Clerck

et al. 2013

Wilderness & Environmental Medicine

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Section: Discussionmentioning

confidence: 99%

A Novel Mouse Model for Frostbite Injury

Auerbach

Galvez

Clerck

et al. 2013

Wilderness & Environmental Medicine

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“…The main requirements to perform soft tissue reconstruction are the availability of a solid bone framework, vessels close enough to an injury site capable of sustaining blow flow requirements for the free flap, a stable patient, and a skilled surgeon. The study by Delgado et al [7] indicates for the first time that axial pattern flaps exhibit a greater integration rate than grafts in the treatment of frostbite. Local and regional flaps improve padding, prevent additional contractures by neovascularization, and allow revascularization of surrounding structures, such as bones and tendons.…”

Section: Discussionmentioning

confidence: 99%

“…Due to the size of the defect and the mechanism of the injury, local flaps are most often inadequate [6]. There are multiple options for the free flap reconstruction of complex soft tissue defects in the foot region, such as a free medial plantar flap, a free groin flap, a free anterolateral thigh flap, or a free anteromedial thigh flap [7,8]. The anterolateral thigh flap (ALT) is one of the best options for reconstruction.…”

Section: Introductionmentioning

confidence: 99%

Feet Salvage Using Anterolateral Thigh Flaps after Severe Frostbite Injury: A Case Report

Martić,

Vojvodić,

Gorjanc

et al. 2024

JPM

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Background: Frostbite is a severe injury characterized by tissue damage due to exposure to freezing temperatures. It often necessitates prompt medical intervention to prevent further complications such as necrosis and amputation. This case report explores the successful use of bilateral anterolateral thigh (ALT) free flaps for feet salvage in a 19-year-old male refugee from Gambia who suffered severe frostbite injuries. Case Report: The patient, found after six days in freezing conditions, exhibited necrosis on multiple toes. Initial management included stabilization, intravenous fluids, and rewarming. Subsequent necrectomy and amputation revealed exposed metatarsal bones, necessitating a meticulous reconstructive strategy. Bilateral ALT flaps were chosen to preserve walking function, with a staged reconstruction involving multiple operations. The patient’s progress, from inpatient care to outpatient follow-ups, is detailed, emphasizing the challenges and decisions in managing severe frostbite injuries. Results: The surgical intervention utilizing bilateral ALT flaps successfully salvaged the patient’s feet. Throughout the postoperative period, wound care, rehabilitation, and outpatient monitoring contributed to positive outcomes. Despite challenges associated with the patient’s ethnic background and nutritional status, the staged reconstruction facilitated effective healing and functional recovery. The use of ALT flaps provided a reliable solution with minimal donor site morbidity. Conclusion: This case highlights the efficacy of bilateral ALT flap reconstruction in salvaging feet following severe frostbite injury. The successful restoration of foot function underscores the importance of early intervention and tailored reconstructive approaches in frostbite management. Despite patient-specific challenges, including nutritional status and limited healthcare resources, the use of ALT flaps facilitated optimal recovery and functional outcomes. Importantly, this report is unique as it describes a novel case of feet salvage using bilateral ALT flaps in severe frostbite injury, with only one similar case previously reported in the literature. This emphasizes the rarity and significance of this specific surgical approach in frostbite management.

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“…A lack of reliable preclinical animal models to explore the cellular and molecular mechanisms of frostbite injuries has slowed the discovery of new and effective interventions. 3,4,10 -14,36 -51 A recently described mouse model of frostbite 10 may be an efficient, reliable, and reproducible model for evaluating new treatments and investigating cellular and molecular mechanisms associated with frostbite.…”

Section: Discussionmentioning

confidence: 99%

Dexamethasone Improves Wound Healing by Decreased Inflammation and Increased Vasculogenesis in Mouse Skin Frostbite Model

Zhang

Barksdale

et al. 2020

Wilderness & Environmental Medicine

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IntroductiondFrostbite is thought to result from initial vasoconstriction, ischemia, intracellular ice crystal formation, and inflammation caused by reperfusion injury. Corticosteroids have demonstrated beneficial anti-inflammatory effects in the treatment of other ischemia/reperfusion clinical conditions. The objective of this study was to determine the effect of dexamethasone (dex) on wound healing, inflammatory response, and vasculogenesis in a mouse skin frostbite model. MethodsdTreatment and control groups of C57/BL6 mice were subjected to frostbite using a previously described model. Treatment with intraperitoneal dex (1 mg$kg-1 $d-1) began on the day of frostbite induction and lasted for 7 d. Over 4 wk, we compared wound diameter; morphology by visual inspection, hematoxylineeosin staining, and Masson's trichrome staining; density of inflammatory cytokines IL-1b and TNFa using Western blot analysis; and formation of microvasculature using immunofluorescence staining. Data were analyzed using 1-way or 1-way repeated-measures analysis of variance. ResultsdAfter frostbite injury, morphological images demonstrated epidermal necrosis and loss in the frostbitten skin as well as infiltration of inflammation-related leukocytes. Increased production of inflammatory cytokines and disappearance of the microvasculature also occurred in the frostbitten skin. In comparison to the control group, treatment with dex promoted wound healing as demonstrated by decreased wound diameter; decreased levels of inflammatory cytokines, and accelerated formation of mature microvasculature. ConclusionsdIn this animal model, dex improved wound healing in frostbitten skin and demonstrated both anti-inflammatory effects and stimulation of vasculogenesis. This study suggests that the use of potent anti-inflammatory agents may be an effective strategy for mitigating frostbite injury.

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Skin coverage in frostbite injuries: Experimental study

Cited by 7 publications

References 16 publications

A Novel Mouse Model for Frostbite Injury

A Novel Mouse Model for Frostbite Injury

Feet Salvage Using Anterolateral Thigh Flaps after Severe Frostbite Injury: A Case Report

Dexamethasone Improves Wound Healing by Decreased Inflammation and Increased Vasculogenesis in Mouse Skin Frostbite Model

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