Studies on Gangrene Following Cold Injury. Ii. General Course of Events in Rabbit Feet and Ears Following Untreated Cold Injury 1

Fuhrman, Frederick A.; Crismon, J. M.

doi:10.1172/jci101801

Cited by 21 publications

(15 citation statements)

References 1 publication

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“…Also there have been many studies on frostbitten tissue experimentally about the physiopathogenesis of frostbite [2]. It is revealed that frostbite injury causes direct cellular damage and death and the second one is progressive tissue ischemia [3][4][5][6][7][8][9]. Acute effects of frostbite can be seen as formation of extracellular ice crystals.…”

Section: Discussionmentioning

confidence: 99%

The current analysis of the effect of hyperbaric oxygen therapy on the frostbitten tissue: Experimental study in rabbits

et al. 2009

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AbstractMany experimental studies have been performed and the mechanism of hyperbaric oxygen therapy on the frostbitten tissue has not been elucidated. In this study, we evaluated the effect of hyperbaric oxygen therapy on the frostbitten ears of rabbits in an experimental animal model by examining the concentrations of thromboxane A2 (as thromboxane B2-Tx B2) and of prostaglandin I2 (PG I2) (as 6-keto-prostaglandin F1α-PG F1α) in tissues, and by counting the numbers of inflammatory cells (neutrophils and mast cells-MC) Hyperbaric oxygen therapy (HBO) at 2.5 ATA for 90 minutes twice daily for fourteen days to rabbits, the ears of which were subjected to frostbite, decreased presence of inflammatory cells (mast cells −75%; neutrophils −40%) and increased prostaglandin I2 (PG I2) (as 6-Keto-PGF1α) in the involved skin. Thromboxane A2 (TxA2) (as Tx B2) was unaffected. Our results revealed that an inflammatory process was the underlying cause of frostbite injury and that hyperbaric oxygen therapy was active in pathological situations involving an inflammatory process in frostbite.

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Section: Discussionmentioning

confidence: 99%

The current analysis of the effect of hyperbaric oxygen therapy on the frostbitten tissue: Experimental study in rabbits

et al. 2009

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“…In untreated experimental frostbite, the skin temperature of injured feet of rabbits declined gradually over a period of about 48 hours until the temperature was approximately that, of the environment (1). When skin temperature measurements were made on casted feet by means of thermocouples on the skin and enclosed in the cast, it was found that those parts which survived the injury remained warm while those destined to become gangrenous in spite of the treatment suffered the usual fall in temperature.…”

Section: Discussionmentioning

confidence: 99%

“…(Received for publication December 16,1946) It has been reported in a previous communication (1) that increased leakage of fluid from capillaries is an invariable consequence of cold injury in rabbits' ears and feet. Although stasis in the true-capillaries was observed to occur in ears about 10 minutes after injury, it could be delayed by several procedures (2).…”

mentioning

confidence: 95%

Studies on Gangrene Following Cold Injury. Viii. The Use of Casts and Pressure Dressings in the Treatment of Severe Frostbite 1

Crismon¹,

Fuhrman²

1947

J. Clin. Invest.

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It has been reported in a previous communication (1) that increased leakage of fluid from capillaries is an invariable consequence of cold injury in rabbits' ears and feet. Although stasis in the true-capillaries was observed to occur in ears about 10 minutes after injury, it could be delayed by several procedures (2). The delayed appearance of stasis in the treated ears, as well as the invariable late occurrence of stasis at the junction between the normal and frostbitten regions of an ear, suggest that distortion of the tissues, resulting from the massive edema, may close true capillaries and produce stasis. The effect of capillary closure in limiting the exchanges between the blood stream and the cells is an important one.The similarity between the vascular lesion in frostbite and in burns is obvious and has been pointed out previously by others (3). Glenn (4) has recently reviewed the development of the treatment of burns by means of external pressure and by means of non-elastic, non-distensible dressings. Whether the good results of these forms of treatment depend upon "the control of capillary leakage" as suggested by Glenn or whether the benefit may derive from prevention of the mechanical distortion produced by swelling has not been determined. However, measures which aim at the control of either of these consequences of heat injury find equal justification for their use in the treatment of frostbite.Two different types of dressings are available for the mechanical control of fluid loss following injury: I (a) Closed plaster casts were used by Glenn, Gilbert, and Drinker (5) for the treatment of experimental burns. The rationale of this procedure has been described by Glenn (4): "As plasma es- capes from the dilated hyperpermeable capillaries, the extravascular tissue fluid pressure quickly builds up against the rigid encasement to exactly equal the pressure attempting to push fluid out of the capillaries." Such dressings should be skintight, non-elastic and non-distensible. In order to be maximally effective they should be applied before swelling of the injured part has taken place, and they must be applied in such a way that the distal part of the limb is encased in the dressing.(b) External pressure to control fluid loss, as used by Allen and Koch (6) and others, is applied in the form of a pressure dressing of elastic material. A layer of padding separates the tissue from the elastic bandage and serves to equalize the pressures within the dressing. This form of dressing offers no obvious advantages over rigid casts for immediate treatment of frostbite in the period before swelling has begun. METHODSStandard cold injury. Injury was produced by immersing the hind feet of rabbits in a mixture of water, ethylene glycol, and alcohol cooled by the addition of solid carbon dioxide. The times of exposure and the temperatures used included those from 15 to 60 minutes at -15°C. and 2 and 3 minutes at -550 C. Details of standardization of cold injury produced by this means are given in the first paper of this s...

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“…It has been pointed out that the edematous tissues after frostbite are to some extent organized (1), in that only limited quantities of edema fluid flow from the incised, swelling. Organization of this fluid either in the form of a fibrin clot or in a gel stabilized by hyaluronic acid (11) might offer some mechanical barrier to free movement of fluid and plasma protein in the extravascular compart-ment and also hinder the movement of fluid into capillaries even though adequate filtration gradients existed.…”

Section: Observationsmentioning

confidence: 99%

“…Indirect evidence, based upon measurements of skin temperature and observations of skin color in the feet and ears of rabbits subjected to severe cold injury, indicates that complete arrest of blood flow does not occur until more than 50 hours after injury (1). Tests of the local circulation in coldinjured regions with intravenously injected fluorescein show that the exchange of this dye between blood and interstitial fluid is impaired during the interval when the minute volume blood flow is greater than that in comparable uninjured regions (2,3).…”

mentioning

confidence: 99%

Studies on Gangrene Following Cold Injury: Vi. Capillary Blood Flow After Cold Injury, the Effects of Rapid Warming, and Sympathetic Block 1

Crismon

Fuhrman²

1947

J. Clin. Invest.

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Indirect evidence, based upon measurements of skin temperature and observations of skin color in the feet and ears of rabbits subjected to severe cold injury, indicates that complete arrest of blood flow does not occur until more than 50 hours after injury (1). Tests of the local circulation in coldinjured regions with intravenously injected fluorescein show that the exchange of this dye between blood and interstitial fluid is impaired during the interval when the minute volume blood flow is greater than that in comparable uninjured regions (2, 3). Early arrest of blood flow in regions injured by cold has been variously ascribed to "conglutination" of red-cells (4), to capillary stasis (5), and to intravascular clotting (2). While all of the above phenomena may be observed in frostbitten tissues, none has provided an explanation of the nature of local changes in blood flow adequate to account for the maintenance of high peripheral tissue temperature at a time following cold injury when exchanges of oxygen, nutrients, and metabolites appear to be impaired.This report presents the results of microscopic study of blood flow in the small vessels of the ears of rabbits during the first hour after freezing. Blood flow was also studied in the ears of animals which were treated by rapid thawing of the ear in warm water and by procaine block of the stellate ganglion on the injured side. METHODSCold injury was produced by immersing the distal one-half to one-third of the ear for 60 seconds in a mixture of water, ethylene glycol, and alcohol cooled to -550 C. with solid carbon dioxide. Details of this method for the production of controlled cold injury and the characteristic effects on the tissues are given elsewhere (6).X The work described in this paper was done under a contract, recommended by the Committee on Medical Research, between the Office of Scientific Research and Development and Stanford University.Both normal and frostbitten ears of a uniform strain of New Zealand white rabbits were observed through a binocular dissecting microscope having 9X oculars and 4.8X objectives. The light sources was a 100-watt Spencer microscope lamp from which the light was conducted to the ear by means of a polished rod of %-inch methyl methacrylate (Lucite) 2 feet long. The rod was tapered to a cone having a rounded tip 7 mm. in diameter. The distal 8 inches of rod were bent into a curve which presented the brilliantly illuminated tip at a right angle to the original path of light. WiAh the rod in an adjustable clamp, its flattened end in contact with the blue glass of the microscope lamp, the ear was placed under the objectives of the microscope in direct contact with the methacrylate rod. Liquid petrolatum was applied to the shaved ear in order to clear the keratinized epithelium. Photographic recording of the changes observed proved to be unsatisfactory because of the thickness of tissue and the changing optical plane. OBSERVATIONSBlood flow in the capillaries of the normal ear.Movement of blood could not be seen in the larger...

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Studies on Gangrene Following Cold Injury. Ii. General Course of Events in Rabbit Feet and Ears Following Untreated Cold Injury 1

Cited by 21 publications

References 1 publication

The current analysis of the effect of hyperbaric oxygen therapy on the frostbitten tissue: Experimental study in rabbits

The current analysis of the effect of hyperbaric oxygen therapy on the frostbitten tissue: Experimental study in rabbits

Studies on Gangrene Following Cold Injury. Viii. The Use of Casts and Pressure Dressings in the Treatment of Severe Frostbite 1

Studies on Gangrene Following Cold Injury: Vi. Capillary Blood Flow After Cold Injury, the Effects of Rapid Warming, and Sympathetic Block 1

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