Surgeon’s decision concerning limb amputation after frostbite as a basis of subsequent successful activity of general practitioner-family physician (own clinical observations and experience of education in state and English language)

Abstract

The degree of frostbite depends on environment temperature, cold wind and the duration of exposition. Tissue freezing after the loss of warmth and appearing of ice crystals in superficial and deep tissues are in the basis of frostbite. Because of easy access and peripheral anatomic features frostbites preferably involve distant upper and lower parts of limbs, ears, nose and cheeks. There are wide spectrum of clinical manifestations of frostbites in the range of lesions, which disappear to lesions, which require amputations. Such classification of lesions clinical characteristics is a working classification basing on degree of injury. Even without tissue losses patients may suffer of long-term consequences after frostbites, which can include vasomotor disorders, neuropathic and nociceptive pain and arthritis after frostbites. Article describes own clinical observations of very severe (ending with amputation) frostbite case. We consider submitted description as an informative for discussion during practical classes in state and English languages. Making in time and saving amputation by the surgeon is a very important aspect for the long-term management of patient by primary care physician following rehabilitation program including all necessary vital prescriptions. Described approach to our patient was based on long-term development of manifestations with precise demarcation line and joining of purulent process after frostbite up to the time of his conscious appeal for medical help.