Page R E, Robertson G A
Hand. 1983 Jun;15(2):185-91. doi: 10.1016/s0072-968x(83)80012-6.
Twenty cases of moderate and severe frostbite of the hands were analysed to establish trends in surgical treatment. Excision of large blisters and early mobilization in flamazine bags were found to be beneficial. In those patients whose initial skin changes did not extend to the base of the fingers only minor amputations were necessary. The small amounts of necrotic tissue did not interfere with hand movement and operation was therefore delayed until six or seven weeks, so that maximal digital length could be preserved. In contrast, those patients whose initial skin changes involved the whole length of the fingers or extended on to the hands, more proximal amputations were necessary and these amputations were performed at three to four weeks in order to remove the larger amounts of necrotic tissue and facilitate early mobilisation.
对20例手部中重度冻伤病例进行分析，以确定外科治疗的趋势。发现切除大水疱并早期置于磺胺嘧啶银袋中活动是有益的。对于那些初始皮肤改变未延伸至手指基部的患者，仅需进行小范围截肢。少量坏死组织不影响手部活动，因此手术推迟至6至7周，以便保留最大的手指长度。相比之下，那些初始皮肤改变累及手指全长或延伸至手部的患者，则需要进行更近端的截肢，这些截肢在3至4周时进行，以切除大量坏死组织并促进早期活动。
