ABSTRACT
Frostbite is a tissue injury that occurs when the body is exposed to extreme cold. Its pathological mechanism is complex and has not been fully elucidated. In high cold and high altitude areas, outdoor sports people have a high risk of injury, and severe frostbite has high disability and mortality. Exploring the pathological mechanism of frostbite is helpful to determine the treatment methods and timing. At present, the clinical treatment of frostbite is mainly symptomatic treatment, such as drug treatment and surgical treatment, but the curative effect can not meet the clinical needs. Therefore, it is of great significance to seek more efficient drugs or treatment methods. This article reviews the relevant research progress in pathophysiological mechanism, clinical treatment, cellular and molecular pathways of frostbite in recent years, in order to provide new ideas for future research and clinical treatment.
ABSTRACT
Frostbite in Southwestern China has been overlooked due to its low incidence, relatively mild temperature and lack of literature published before. However, it needs to be further studied for religious diversity and distinct geomorphology. In this article, we reported an 18-year-old Tibetan girl who suffered from blizzard attack during pilgrimage. Her feet and several fingers showed mummified gangrene upon physical examination with poor movement. She was diagnosed with 3rd to 4th degree of frostbite. The girl was given oral ibuprofen, debridement and other regular treatment daily, but she was eventually amputated due to insufficient thrombolytic management in primary hospital, delayed informing consent in the referral hospital and ethnic conflict between religion and guidelines. This case enriched the experience of managing complex frostbite in Tibetan population and alarms that efforts should be integrated to protect pilgrims and mountaineers in the Tibetan region.
Subject(s)
Adolescent , Female , Humans , Amputation, Surgical , China , Frostbite/therapy , Incidence , TibetABSTRACT
A criocirurgia tem sido utilizada no tratamento de diferentes enfermidades de sistemas e órgãos. Contudo, são relatados efeitos adversos, como cicatrização lenta, cicatrizes extensas, disfunção estética e funcional. As lesões que ocorrem naturalmente pela exposição ao frio extremo, comumente, resultam em gangrena. O presente trabalho teve como objetivo avaliar a influência das células-tronco mesenquimais de origem adiposa (ADSCs) na fase de proliferação da cicatrização de feridas cutâneas. Por meio da aplicação do nitrogênio líquido pela técnica do spray aberto, realizou-se a indução de uma ferida, de aproximadamente 15mm de diâmetro, na região dorsal de cada rato. A ferida recebeu o tratamento de acordo com o grupo ao qual pertencia: 1) aplicação das ADSCs no 15º dia (grupo tratado); 2) aplicação da solução cloreto de sódio 0,9% no 15º dia (grupo sham); 3) nenhuma intervenção até o momento da eutanásia (grupo controle). O grupo tratado com as ADSCs apresentou as maiores taxas de contração média das feridas e obteve diferença estatisticamente significativa em relação ao grupo sham quanto à neovascularização. A terapia com as ADSCs proporcionou uma relevante evolução clínica das feridas, podendo ser constatada ao final do período de avaliação por cicatrizes mais estreitas e compridas.(AU)
Cryosurgery has been used to treat different diseases of systems and organs, although adverse effects have been reported such as delayed wound healing, large scars, esthetical deformation and functional impairment. Injuries caused naturally by the exposure to extreme cold weather conditions mostly result in gangrene. This study aims to evaluate the influence of adipose-derived stem cells (ADSCs) in the proliferation phase on cutaneous wound healing. Through the application of liquid nitrogen by the spraying technique, a 15 millimeter diameter lesion was produced in the dorsal region of each rat. The wound received treatment according to the group it belonged: 1) ADSCs application on the 15th day (treated group); 2) application of 0.9% sodium chloride solution on the 15th day (sham group); 3) no intervention until euthanasia (control group). The group treated with ADSCs showed the highest wound average contraction rate; this group got a significant statistical difference in relation to the sham group when it refers to neovascularization. The ADSCs therapy provides an important clinical evolution of wounds. This was verified at the end of the evaluation period through narrower and longer scars.(AU)
Subject(s)
Animals , Rats , Wound Healing/physiology , Burns/veterinary , Cryosurgery/veterinary , Mesenchymal Stem Cells , Wounds and Injuries/therapy , Rats, Wistar , Cooling Agents , Cold-Shock ResponseABSTRACT
Objective@#To explore the effects of recombinant human granulocyte macrophage colony stimulating factor (rhGM-CSF) gel on treatment of thefull-thickness frostbite wounds on foot and hand.@*Methods@#From November 2013 to April 2017, a total of 45 patients of 71 full-thickness frostbite wounds on foot and hand meeting the inclusion criteria were admitted to the First Hospital of Jilin University and the prospective randomized controlled study was done. The patients were divided into rhGM-CSF group of 24 patients with 35 wounds and control group of 21 patients with 36 wounds according to the random number table. There were 20 males and 4 females, aged (38±13) years among patients in rhGM-CSF group, and there were 19 males and 2 females, aged (36±14) years among patients in control group. Patients in 2 groups were performed with the same systemic treatment of rewarming, anti-inflammation, pain relief, anti-infection, anti-coagulation, and thrombolysis. Wounds of patients in rhGM-CSF group and control group were respectively treated with rhGM-CSF gel and aloe vera gel for external usage with 10 mg for every square centimeter and dressing change once every 24 hours, until wounds healed completely. The wound inflammatory response was scored on treatment day (TD) 1, 3, 7, 14, wound secretion was collected for bacteria culture and positive bacteria detection rate was calculated before treatment and on TD 6 and 12, adverse drug reaction after drug use was observed, and the complete wound healing time was recorded. Data were processed with Fisher′s exact probability test, analysis of variance for repeated measurement, t test, and Bonferroni correction.@*Results@#The scores of wound inflammatory response of patients in 2 groups on TD 1 and 3 were close (t=0.37, 2.93, P>0.05). The scores of wound inflammatory response of patients on TD 7 and 14 in rhGM-CSF group were significantly higher than those in control group (t=5.77, 5.83, P<0.01). The results of bacteria culture of wound secretion of patients in 2 groups before treatment were negative. The positive bacteria detection rates of wound secretion of patients in rhGM-CSF group on TD 6 and 12 were 5.71% (2/35) and 22.86% (8/35), which were slightly lower than 13.89% (5/36) and 30.56%(11/36) in control group respectively, but there was no significantly statistical difference (P>0.05). No adverse drug response occurred in patients in rhGM-CSF group, while 1 patient in control group had adverse drug response, with symptoms of redness and swelling of wounds and patchy erythema on skin around wounds, which were alleviated by irrigating with normal saline. The complete wound healing time of patients in rhGM-CSF was (12.3±0.5) d, which was significantly shorter than (16.5±0.8) d in control group (t=24.89, P<0.05).@*Conclusions@#The topical rhGM-CSF gel has effects of shortening time of wound healing and reducing inflammatory response of wound on treatment of full-thickness frostbite wounds on foot and hand, which is safe in clinical application.
ABSTRACT
Cold injury is very damaging. This article summarizes the mechanism, types, and rehabilitation of cold injury, focusing on the degree and clinical treatment of frostbite. Frostbite can mainly cause damage of microcirculation and capillary structure, while burn injury can mainly cause damage of cutaneous tissues. Based on this, the key point of management of frostbite is to improve microcirculation and appropriate rewarming, while that of burn injury is wound repair. Up to date, the rate of amputation caused by frostbite is still high, and the rehabilitation for sequela caused by frostbite remains a big challenge in modern medicine. It is worth paying more attention to.
ABSTRACT
Severe frostbite (grade Ⅲ to Ⅳ) is a common disease accompanied with high disability rate in cold regions, especially for military training and disaster events in cold regions. The treatment of severe frostbite mainly includes rapid rewarming in the early stage and amputation in the later stage; while the damage of vascular endothelial cells, microvascular thrombosis, and decreased tissue perfusion secondary to severe frostbite are important factors affecting prognosis. Transcatheter arterial thrombolysis is a new technique for the treatment of severe frostbite. It has the advantages of minimally invasive, high safety, and significantly reduced amputation rate. We reviewed the advances in the research of transcatheter arterial thrombolysis for the treatment of severe frostbite.
ABSTRACT
The human capacity for physiologic adaptation to cold is minimal. A cold environment can be a threat to the skin, leading to a subsequent fall in core body temperature. Many physiologic, behavioral, and environmental factors predispose to the global effects of cold injuries. Physical injuries caused by cold have two forms: systemic forms such as hypothermia and localized forms such as frostbite. Reduced temperature directly damages the tissue, as in frostbite and cold immersion foot. Vasospasm of vessels perfusing the skin induces chilblain, acrocyanosis, and frostbite. The degree of damage caused by cold is related to four factors: temperature, exposure time, wind intensity (temperature sensation), and high altitude.
Subject(s)
Humans , Adaptation, Physiological , Altitude , Body Temperature , Chilblains , Cold Injury , Frostbite , Hypothermia , Immersion Foot , Skin , WindABSTRACT
The diagnosis, treatment, operation and diagnosis of two cases of occupational frostbite diagnosed in Shandong Academy of Occupational Healthy Occupational Medicine were analyzed retrospectively. In these two patients working in a low temperature environment, the finger frostbite did not arouse enough attention, one patient did not receive timely diagnosis and treatment, and one patient received timely medical treatment, but did not receive proper treatment, which ultimately led to the adverse consequences of finger amputation. The staff under the low temperature environment should strictly carry out the low temperature operation protection standard and improve their self-protection consciousness. If frostbite occurs, they should seek medical treatment in time, which can effectively reduce the disability rate.
ABSTRACT
Burns are among the most severe injuries the human body can withstand, as they are life-threatening and therefore require prompt treatment with debridement and use of biological substitutes for a better prognosis. This case report concerns an 18-year-old patient on the 42nd day of puerperium who used ice packs on the right breast to alleviate breast engorgement and pain. After a prolonged period of use, it progressed to hyperemia and, subsequently, an extensive area of necrosis in the skin of the right breast, reaching the subcutaneous adipose tissue, compatible with a third-degree burn. Surgical debridement of the necrotic areas was performed, followed by the use of biological skin substitutes until complete healing of the local skin, not requiring grafting at first. Cryotherapy should be used with caution. Treatment with clinical support and fast surgical intervention can minimize the impact of burns
As queimaduras estão entre as mais graves lesões que o corpo humano pode suportar, visto que ameaçam a vida e requerem, portanto, um tratamento precoce com debridamento e uso de substitutos biológicos para melhora do prognóstico. O presente relato de caso diz respeito a uma paciente de 18 anos de idade no 42º dia de puerpério que realizou compressas com gelo na mama direita para melhora de ingurgitamento mamário e mastalgia. Após longo período de uso, evoluiu com hiperemia e, posteriormente, extensa área de necrose na pele da mama direita, atingindo o tecido adiposo subcutâneo, compatível com uma queimadura de terceiro grau. Foi realizado debridamento cirúrgico das áreas de necrose, seguido do emprego de substitutos biológicos da pele até a completa cicatrização da pele local, não necessitando de enxertia em um primeiro momento. Recomenda-se que a crioterapia deve ser utilizada com cautela. O tratamento com suporte clínico e a intervenção cirúrgica rápida podem minimizar o impacto das queimaduras.
ABSTRACT
Frostbite is a common disease in winter, and systemic or local injury caused by low temperature invasion. Frostbite sites are commonly face, ears, nose, hands, feet and other peripheral blood circulation parts. The main symptoms are pale skin, cold, pain and numbness, skin itching in high temperature, and severe cases may suffer from skin erosions and ulcers. Frostbite model is a pathological model mainly based on Western medicine index. Based on the analysis of clinical symptoms of frostbite in traditional Chinese medicine and western medicine, and a large number of experimental studies on the existing animal models, the animal model preparation of specifications (draft) was formulated as follows.
Subject(s)
Animals , Cold Temperature , Frostbite , Models, AnimalABSTRACT
Objective To determine the difference in blood microcirculation recovery between normal frostbite and high-altitude frostbite during the wound healing.Methods Twenty four male rats were randomly divided into control group (n=8), normal frostbite group (n=8), and high-altitude group (n=8). The normal frostbite group rats were frozen to produce mid-degree frostbite models by controlling the freezing time with liquid nitrogen penetration equipment. The high-altitude frostbite group rats were acclimated to a hypoxic and low-pressure environment for 1 week, and then the high-altitude frostbite models were constructed by the same way with liquid nitrogen penetration apparatus. On days 3, 7, 11, 15, 19, and 23 after modeling, the recovery situation of blood circulation of each group was observed with contrast ultrasonography by injecting SonoVue micro-bubble into rats' tail. Finally, the micro-bubble concentration (MC) was calculated to confirm the blood circulation recovery with software Image Pro. ResultsAt different time points, the wound area of the high-altitude frostbite group was bigger than that of the normal frostbite group, and the MC of control group was always about (27±0.2)×109/ml. On day 3, 7, 11, 15, 19, and 23, the MC was significantly lower in the high-altitude frostbite group than in the control group and normal frostbite group (P<0.05). The MC of normal frostbite group was significantly lower than that of the control group on day 3, 7, 11, 15 and 19 (P<0.05). In addition, no obvious difference in MC was found between normal group and control group on the 23th day (P<0.05).Conclusion The blood microcirculation recovery after high-altitude frostbite is significantly slower than the normal frostbite.
ABSTRACT
Objective To develop an ultrasonic frostbite treatment instrument to enhance the efficiency of its treatment.Methods The instrument was designed with thermal effect of ultrasound,which used LPC1788 controller as the core of the hardware circuit.Corresponding software was developed based on KEIL uvision4.0 platform.The instrument was composed of the circuits for square wave generation,boosting,transduction,LCD and power source.Results Five-to-seven-day treatment by the instrument gained high efficacy,and no adverse response occurred.Conclusion The instrument has the characteristics of high reliability,strong controllability,wide adaptation and no side effects,and thus is worthy promoting practically for the clinical treatment of frostbite.
ABSTRACT
The objective of this study was to prepare nanostructured lipid carrier (NLC)-based topical gel of Ganoderma Triterpenoids (GTs) and evaluate their effects on frostbite treatment. GT-NLCs was prepared by the high pressure homogenization method and then characterized by morphology and analyses of particle size, zeta potential, entrapment efficiency (EE), and drug loading (DL). The NLCs was suitably gelled for skin permeation studies in vitro and pharmacodynamic evaluation in vivo, compared with the GT emulgel. The GT-NLC remained within the colloidal range and was uniformly dispersed after suitably gelled by carbopol preparation. Transmission electron microscopy (TEM) study showed GT-NLCs was spherical in shape. The EE (%) and DL (%) could reach up to (81.84 ± 0.60)% and (2.13 ± 0.12)%, respectively. The result of X-ray diffractograms (XRD) showed that GTs were in an amorphous state in the NLC-gel. In vitro permeation studies through rat skin indicated that the amount of GTs permeated through skin of GT-NLCs after 24 h was higher than that of GT emulsion, and GT-NLCs increased the accumulative amounts of GTs in epidermis 7.76 times greater than GT emulsion. GT-NLC-gel was found to possess superior therapeutic effect for frostbite, compared with the GT emulgel. The NLC based topical gel of GTs could improve -their therapeutic effect for frostbite.
Subject(s)
Animals , Humans , Male , Rats , Drug Carriers , Chemistry , Drugs, Chinese Herbal , Chemistry , Frostbite , Drug Therapy , Ganoderma , Chemistry , Gels , Chemistry , Lipids , Chemistry , Nanostructures , Chemistry , Rats, Sprague-DawleyABSTRACT
Squamous cell carcinoma commonly originates from recalcitrant wound sites, including burn scars, pressure sores, stasis ulcers, osteomyelitis, and sites of frostbite. A 62-year-old male was referred to the dermatology department for skin necrosis of his right great toe and walking difficulty. He had a history of smoking, drinking alcohol, and frostbite of his right great toe 9 years prior, which deteriorated into osteomyelitis due to poor care. Although a skin biopsy was recommended before amputation, the two procedures were performed simultaneously due to a lack of toe function due to severe osteolysis. Biopsy of the amputated toe tip showed many lobules consisting of atypical keratinocytes with hyperchromatic nuclei, and severe dermal pleomorphism. After evaluation for distant metastasis, including a (99m) Tc-MDP bone scan, 18F-FDG positron emission tomography scan, computed tomography, and ultrasound, no metastasis was detected.
Subject(s)
Humans , Male , Middle Aged , Amputation, Surgical , Biopsy , Burns , Carcinoma, Squamous Cell , Cicatrix , Dermatology , Drinking , Fluorodeoxyglucose F18 , Frostbite , Keratinocytes , Necrosis , Neoplasm Metastasis , Osteolysis , Osteomyelitis , Positron-Emission Tomography , Pressure Ulcer , Skin , Smoke , Smoking , Toes , Ultrasonography , Varicose Ulcer , Walking , Wounds and InjuriesABSTRACT
BACKGROUND: This paper discusses the treatment protocol for patients with frostbite. METHODS: We performed a retrospective analysis of a series of 17 patients with second- and higher-degree frostbite who had been treated at our medical institution between 2010 and 2012. RESULTS: Our clinical series of patients (n=17) included 13 men and four women, whose mean age was 42.4+/-11.6 years (range, 22-67 years). The sites of injury include the foot in six patients (35.3%), the hand in six patients (35.3%) and the facial region in five patients (29.4%). Seven patients with second-degree frostbite were completely cured with only conservative treatment during a mean period of 12.7+/-3.3 days (range, 8-16 days). Of the five patients with third-degree frostbite, two underwent skin grafting following debridement, and the remaining three achieved a complete cure with conservative treatment during a mean period of 35+/-4.3 days (range, 29-39 days). Five patients with fourth-degree frostbite were treated with surgical procedures including amputation. CONCLUSIONS: With the appropriate conservative management in the early stage of onset, surgeons should decide on surgery after waiting for a sufficient period of time until the demarcation of the wound. Continuous management of patients is also needed to achieve functional recovery after a complete cure has been achieved. This should also be accompanied by patient education for the avoidance of re-exposure to cold environments.
Subject(s)
Female , Humans , Male , Clinical Protocols , Cold Temperature , Debridement , Foot , Frostbite , Hand , Patient Education as Topic , Retrospective Studies , Skin Transplantation , Surgical Procedures, OperativeABSTRACT
BACKGROUND:In order to promote the recovery of nerve function after peripheral nerve injury, we should try to accelerate the regeneration of injured nerve axons on one hand, and try to improve the accuracy of proximal and distal nerve docking on the other hand. OBJECTIVE:To explore the selective regeneration of nerve axons after peripheral nerve injury in models with crush injury and freeze injury. METHODS:Total y 110 healthy male Sprauge-Dawley rats, 8 weeks old, were selected and randomly divided into three groups. The rates received crush injury, freeze injury and normal control ed surgery on femoral nerve trunk. At 2, 3, 6 and 12 weeks after modeling, general behavioral examination was performed, and then pure blue and red fluorescence were used to label the wrong-way ingrowth saphenous nerve and correct ingrowth femoral nerve muscular branches respectively;retrograde labeling the motor neurons in order to observe the distribution and amount of tracer in spinal cord anterior horn;electrophysiological examination was performed at 8 weeks after modeling, and analyzed statistical y. RESULTS AND CONCLUSION:Rats from both crush injury group and freeze injury group displayed decreased motion radius of hind limbs after surgery, and the stretch function was limited;but with time prolonging, the functions were recovered. The motor evoked potentials could be observed at the quadriceps, and there was no significant difference between two groups (P>0.05). The number of neurons stained red in the spinal cord anterior horn was increased gradual y in both crush injury group and the freeze injury group under fluorescence microscope. The number of neurons stained red in the crush injury group was significantly higher than that in the freeze injury group (P<0.05), and the number of blue-stained and purple-stained neurons was decreased gradual y. The results suggest that keeping the perineurium intact can gain accurate docking in axon regeneration and the recovery of injured limb functions, even though the damaged range is large.
ABSTRACT
Chilblains are an inflammatory skin condition that develops following exposure to the cold. They consist of pruritic and/or painful erythematous-to-violaceous acral lesions and are the result of an abnormal vascular response to exposure to the cold. This benign condition is common in southern Brazil, particularly in Rio Grande do Sul where climatic conditions, together with cultural and economic aspects, facilitate the development of these sores.
Eritema pérnio é uma condição inflamatória da pele que ocorre após exposição ao frio e se manifesta com lesões eritêmato-violáceas, pruriginosas e dolorosas nas extremidades. Ocorre devido a uma resposta vascular alterada à exposição ao frio. Esta condição benigna é frequente na região sul do Brasil, especialmente no Rio Grande do Sul, onde as características clínicas, associadas a aspectos culturais e econômicos, promovem o desenvolvimento do eritema pérnio.
Subject(s)
Adult , Female , Humans , Chilblains/diagnosis , Hand Dermatoses/diagnosis , Chilblains/etiology , Fingers , Geography, Medical , Hand Dermatoses/etiologyABSTRACT
OBJECTIVE: To explore the therapeutic effect of compound Lingzhi cream for mild frostbite on rabbit ears. METHODS: Rabbit ears were immersed into alcoholic freezing chamber at -24.5°C to cause mild frostbite, then the therapeutic effect of compound Lingzhi cream of different formula was explored after smearing the cream on the injured site, using appearance change, swelling and distension degree, survival area and pathological change of the ears as the observation index. RESULTS: Compound Lingzhi cream formula 2 was effective on mild frostbite of rabbit ears to some extend, but the effect was not as obvious as those of compound Lingzhi cream formula 3 and 4. CONCLUSION: The effective dosage of compound Lingzhi cream on mild frostbite of rabbit ears is 0.5 g crude Lucid Ganoderma and 0.25 g crude Cowherb Seed in 1 g cream. The optimal dosage is 1 g cream containing 1 g crude Lucid Ganoderma and 0.5 g crude Cowherb Seed. The therapeutic effect would not further increase when increasing the drug dosage. Copyright 2012 by the Chinese Pharmaceutical Association.
ABSTRACT
PURPOSE: Frostbite can affect people involved in winter sports, homeless and soldiers. It results in tissue necrosis from direct cellular damage and indirect damage secondary to vasospasm and the progressive microvascular thrombosis following reperfusion of the ischemic limb. However, the frostbite is under-estimated by the physicians. We describe the assessment and management of frostbite and identify the challenges of managing these complex tissue injuries. METHODS: A retrospective analysis of 62 injuries (61 men, average age; 20.5 yo) was conducted between August 2009 to April 2011 in the burn center of AFCH. We sought to determine the demographic characteristics, identification of soft tissue injury, treatment and complications. RESULTS: The 62 were treated as outpatients (n=23, 37.1%) or inpatients (n=39, 62.9%). The superficial degree was 38 (61.3%), while 24 (38.7) have deep degree. The 47.4% of superficial and 87.5% of deep frostbite were admitted. The sites most prone to frostbite were feet (95.2%), followed by hands (27.4%). The toes had the more deep injuries. The 6 cases (9.7%) occurred in wet circumstances. They had suffered more deep injuries than dry circumstances (66.6% vs 35.8%). Thirteen (33.3%) of inpatients were transferred to center 14 days after exposure. The increased levels of isoenzymes did not present the degree of injuries. The bone scan was performed in 22 (56.4%) of inpatients at average 11.3 PFD. We believe it showed an excellent correlation with clinical course, though not confirmed statistically. The patient was treated with rapid rewarming (7; 11.3%), hydrotherapy (11; 17.7%), STSG (3; 12.5 of deep frostbite), berasil (14; 22.6%) and ibuprofen (5; 8.1%). The PGE1 was administered to 34 (87.2%) of inpatients for 8.8 days. We believe the effect of PGE1 to prevent amputations, though not confirmed in evidence base. The sequelae of 9 (23.1%) inpatients included of paresthesia (10.3%), LOM (10.3%), Raynaud's syndrome (7.7%) and hyperhydrois (2.6%). CONCLUSION: In a military context, health education of troops is necessary to avoid moisture circumstances and to protect from cold injuries. We need new guideline to recommend early rewarming and evacuation to specialized units so that the degree of frostbite can be alleviated and rate of complication can be lowered. We need new principles to use NSAIDs, pentoxifylline, antiprostaglandin agents and thrombolytic therapy in amelioration of tissue damage. Together with initial aids, use of radiological assessment, triple phase bone scanning, Duplex studies, Plethysmograpy and future advancements should allow for a more aggressive and active approach to the management of tissue viability. This information is only a primer and requires continuous updating to improve patient outcomes.
Subject(s)
Humans , Male , Alprostadil , Amputation, Surgical , Anti-Inflammatory Agents, Non-Steroidal , Burn Units , Cold Temperature , Extremities , Foot , Frostbite , Hand , Health Education , Hydrotherapy , Ibuprofen , Inpatients , Isoenzymes , Military Personnel , Necrosis , Outpatients , Paresthesia , Pentoxifylline , Reperfusion , Retrospective Studies , Rewarming , Soft Tissue Injuries , Sports , Thrombolytic Therapy , Thrombosis , Tissue Survival , ToesABSTRACT
Facial scar is one of the most common problems in plastic surgery department. Many various methods are attempted to improve facial scars, but there is no definite satisfactory method on scar revision. Authors have been interested in a tendency to show good results when traumatic lacerations were accompanied by abrasions. The improved appearance of the scars with this situation is the result that there were fewer elevations and depressions, and no break in continuity of the epidermal covering on both sides of the scar. But mechanical or other dermabrasive methods have a risk of hyperpigmentation. Authors suggest the scar revision with frostbite using dry ice. This method has little hyperpigmentation due to the sensitivity of melanocytes to cold injury. And the tissue destruction is progressed selectively because of the resistance of collagen against the cold injury and the preserved dermal fibrous network as the structural framework. These characteristics of cryotherapy improve the result of scar revision with fewer side effects rather than other dermabrasive methods. We performed this method to 349 patients from 1993 to 2003 and obtained high patients' satisfaction (85.9% more than fair). Moreover, this method is simple, cheap and handy. In conclusion, the scar revision with frostbite using dry ice is very useful method to improve facial scars.