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Hand Clin. 2009 Nov;25(4):481-96. doi: 10.1016/j.hcl.2009.06.004.

Cold injury.

Author information

1
The Burn Center, Department of Trauma and General Surgery, Regions Hospital, Mail Stop 11105C, 640 Jackson Street, St. Paul, MN 55101, USA. william.j.mohr@healthpartners.com

Abstract

The pathophysiology of true frostbite reveals that the direct injury produced during the initial freeze process has a minor contribution to the global tissue damage. However, rapid rewarming to reverse the tissue crystallization has essentially been the lone frostbite intervention for almost half a century. The major pathologic process is the progressive microvascular thrombosis following reperfusion of the ischemic limb, with the cold-damaged endothelial cells playing a central role in the outcome of these frozen tissues. Newer interventions offer the opportunity to combat this process, and this article offers a scientific approach to frostbite injuries of the upper extremities.

PMID:
19801122
DOI:
10.1016/j.hcl.2009.06.004
[Indexed for MEDLINE]

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