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Query: UMLS:C0020672 (hypothermia)
 17,327 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Controversy has surrounded the role of local hypothermia as a preoperative treatment in amputations of the lower extremity. A study was undertaken to determine the effectiveness of amputation under cryoanesthesia in decreasing postoperative morbidity and mortality in below-knee (BK) amputations. Of 154 BK amputations, only 91 with unreconstructable vascular disease, gangrene, or both, were included in this study. Group I consisted of 48 patients (mean age 63.9 years) who had undergone a routine BK amputation; group II consisted of 43 patients (mean age 65.7 years) who were acutely ill and too unstable to undergo a major surgical procedure. Group II patients were treated by amputation while under cryoanesthesia before any definitive operative intervention. The patients in group II were significantly (p less than 0.05) more ill preoperatively than those in group I. Group II patients had a higher prevalence of previous myocardial infarction, previous stroke, diabetes mellitus, osteomyelitis, and wet gangrene. Seventy percent of the patients in group II had three or more risk factors vs. 46% in group I. Early postoperative mortality rates did not differ significantly between groups (group I, 8%; group II, 9%); the average length of hospital stay for group I patients was 24.2 days compared with 17.7 days in group II. Group II patients sustained slightly more postoperative complications. Amputation under cryoanesthesia appears to be of value in reducing postoperative morbidity and mortality and length of hospital stay in the acutely ill patient with unreconstructable vascular disease, gangrene, or both.
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PMID:Below-knee physiologic cryoanesthesia in the critically ill patient. 334 56

The authors present a case of deep frostbite treated with both hyperbaric oxygen and thrombolytic therapies. Both of these therapies are experimental and have not yet achieved widespread clinical use. The patient described in this paper sustained frostbite after becoming intoxicated and falling unconscious in a snowy field. He was treated acutely for hypothermia and came into the authors' care for wound management. Of his 6 digits with extensive, deep frostbite, 1 digit eventually required partial amputation, and another had protracted osteomyelitis treated with intravenous antibiotics. The authors present a case history in the context of current research and provide a listing of previous case reports of hyperbaric oxygen therapy for frostbite.
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PMID:Deep Frostbite Treated With Hyperbaric Oxygen and Thrombolytic Therapies. 2628 75