Fisher Owain L, Benson Ruth A, Venus Matthew R, Imray Christopher H E
Department of Vascular Surgery, University Hospital Coventry and Warwickshire, Coventry, UK.
Department of Vascular Surgery, University Hospital Coventry and Warwickshire, Coventry, UK; Institute of Cancer and Genomic Sciences, University of Birmingham, UK.
Wilderness Environ Med. 2019 Mar;30(1):59-62. doi: 10.1016/j.wem.2018.09.003. Epub 2018 Dec 24.
Extremities are the area of the body most commonly affected by frostbite, which can also affect the face, ears, perineum, or genitals. Optimum management has moved away from early amputation and debridement toward maximizing tissue preservation and delaying surgical intervention. Increasing length of digit amputation increases morbidity, in terms of loss of hand function, experienced by patients. Reconstruction of affected digits is limited by bone necrosis, which often leads to shortened residual stumps and limited functional outcomes. This case describes the management of a severe frostbite injury affecting both hands and feet in a 39-y-old man, sustained during descent of Mount Everest. The use of a pedicled abdominal flap to provide soft-tissue cover permitted optimized digit length and function and sensate digits. The case highlights the benefits of early multidisciplinary team involvement in the management of severe frostbite to optimize functional outcome.
四肢是身体最常受冻伤影响的部位，冻伤也可累及面部、耳朵、会阴或生殖器。最佳治疗方法已从早期截肢和清创转向最大限度地保留组织并延迟手术干预。就患者手部功能丧失而言，手指截肢长度增加会增加发病率。受影响手指的重建受到骨坏死的限制，这通常会导致残留残端缩短和功能结果受限。本病例描述了一名39岁男性在攀登珠穆朗玛峰下山过程中双手和双脚遭受严重冻伤的治疗情况。使用带蒂腹部皮瓣提供软组织覆盖，可使手指长度和功能以及有感觉的手指达到最佳状态。该病例强调了早期多学科团队参与严重冻伤治疗以优化功能结果的益处。
