Strohecker B, Parulski C J
Section of Plastic and Reconstructive Surgery, Pennsylvania State University, Hershey, USA.
Plast Surg Nurs. 1997 Winter;17(4):212-6. doi: 10.1097/00006527-199724000-00005.
Frostbite may be defined as acute freezing of tissues as a result of exposure to temperatures below the freezing point of intact skin. Severity of injury is due to the degree of cold and the duration of exposure. Tissue injury occurs during freezing due to the actual formation of ice crystals within the extracellular fluid. In addition, ice crystals form in the blood and lead to sludging and cessation of capillary blood flow. However, the most severe tissue damage comes with rewarming the tissues. Reperfused capillaries, with their damaged endothelium, leak fluid and protein leading to edema. Blisters form, and prostaglandins and thromboxanes in the blister fluid cause platelet aggregation. Rapid rewarming of the part is now the acceptable practice. Immersion of the injured part in a whirlpool bath is recommended at a temperature of 100 to 108 degrees Fahrenheit. Eventual care may include debridement and tissue transfers if amputation is required. A case is presented of a woman with frostbitten hands.
冻伤可定义为由于暴露于低于完整皮肤冰点的温度而导致的组织急性冻结。损伤的严重程度取决于寒冷程度和暴露持续时间。在冷冻过程中，由于细胞外液中实际形成冰晶，会发生组织损伤。此外，血液中形成冰晶并导致血液淤滞和毛细血管血流停止。然而，最严重的组织损伤发生在组织复温时。重新灌注的毛细血管，其内皮受损，会渗漏液体和蛋白质，导致水肿。水泡形成，水泡液中的前列腺素和血栓烷会导致血小板聚集。现在，对冻伤部位进行快速复温是可接受的做法。建议将受伤部位浸入温度为100至108华氏度的漩涡浴中。最终的治疗可能包括清创术，如果需要截肢，还可能包括组织移植。本文介绍了一名手部冻伤女性的病例。
