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

Cold injury.

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The Burn Center, Department of Trauma and General Surgery, Regions Hospital, Mail Stop 11105C, 640 Jackson Street, St. Paul, MN 55101, USA.


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.

[Indexed for MEDLINE]

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