ENVIRONMENTAL DAMAGE OF THE EXTREMITIES
Both freezing (frostbite) and nonfreezing injuries may damage the extremities. The presence of dampness or peripheral vascular disease enhances the tissue loss for any given temperature reduction or duration of exposure. Tissue damage is probably due to a combination of direct freezing and marked vasoconstriction. Cold produces numbness in tissues that may allow freezing without warning, so that the first indication of frostbite may be a prickling feeling. The affected area initially looks pale or waxy yellow and may be anesthetic In severe frostbite, edema and bullae formation occur with thawing, and gangrene may result. Frostbite should be treated immediately by rewarming, but excessive warming, massage, and exercise should be avoided. Infection is the greatest danger and the affected areas must be handled with aseptic technique.
Prolonged immersion of extremities in water leads to a syndrome known as immersion foot or trench foot. Wetness plus cold produces the most serious form of the syndrome. It does not necessarily require freezing temperatures and is due in part to direct and reflex vasoconstriction.
- THE AIRWAY STRUCTURE
- NONPULMONARY FACTORS
- ARTERIAL TRAUMA
- PULMONARY GAS EXCHANGE
- VENTILATION
- THE BLOOD VESSELS STRUCTURE
- GENERAL PRINCIPLES OF CARDIAC SURGERY
- MISCELLANEOUS AORTIC DISEASE
- RAYNAUD'S PHENOMENON
- THROMBOANGIITIS OBLITERANS
- GENERAL SURGERY IN THE PATIENT WITH HEART DISEASE
- GAS TRANSFER
- NONRESPIRATORY FUNCTIONS OF THE LUNG
- PERFUSION
- PERIPHERAL VENOUS DISEASE
- ENVIRONMENTAL DAMAGE OF THE EXTREMITIES
- PERIPHERAL ANEURYSMS AMD FISTULAE
- ARTERIOSCLEROSIS OBLITERANS
- HEART DISEASE AND PREGNANCY