Frostbite during Kashmir conflict

The aim of this study was to evaluate different modalities of management of cold injuries including gradual re-warming, administration of vasodilators, and surgical intervention. A total number of 2564 cases of frostbite were treated during December 1988 to March 2003, mostly at local hospitals of Muzaffarabad, Azad Kashmir. The frost bitten cases were refugees who suffered frostbite during their movement across the line of control alongside the Himalayan mountains over 12000 feet altitude above sea level. Management of these patients involved multidimensional approach with prudent strategy [if frost bitten in January amputate in June.] The patients were categorized into four groups depending upon the severity of injury. All the patients were gradually rewarmed. The severally injured [100%] and moderately injured patients [50%] were administered 5 mg nifidepine, 5 ml 1% lignocain in femoral vessel, alongwith administration of systemic antibiotics accompanied by limited wound debridement and wound dressing. Patients were watched till clear demarcation line appeared between the live and dead tissue. Sequelae of cold injuries and the rate of complications reduced by adopting this management policy

Chemoprophylaxix in operative cases

Role of chemoprophylaxis was studied in 381 operated cases at Department of Surgery, Combined Military Hospital, Rawalpindi. They were divided into two groups. Group 'A' [188 cases] was given routine antibiotic cover while group 'B' [193 cases] was not given any antibiotic prophylaxis. Both were monitored for post-operative wound infection and other complications. The results of the latter group have in fact been better than the former