• Journal of the Korean Burn Society
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• v.24 no.2
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• pp.21-29
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• 2021

Purpose: Frostbite is a hazard to people exposed to cold environments. With the progression of modern industrial development and change of leisure behavior encountering cold environments, frequent accidental exposure to frostbite injury during work and human behavior is increasing, and the predisposing factors of frostbite were greatly changed than before. The purpose of this study was to make epidemiological analysis, and to review the treatment outcomes of frostbite. Methods: From March 2010 to February 2021, this study has included 27 patients with second- to third-degree frostbite injuries in Advanced Burn Reconstruction Center, Bundang Jesaeng Hosptial. A retrospective study was made about the distribution of age, gender, predisposing factors, prevalent area, type of managements, and the length of treatment period. Results: In our institution, acute management of frostbite patients has included rewarming, anticoagulation therapy (acetylsalicylic acid), and agents to improve vascular perfusion (lipo-prostaglandin E1 [Eglandin^®]). The 25 frostbite patients with second-degree frostbite (92.6%) were successfully managed by the conservative treatment alone with a mean of 20.3 days healing time. Two patients with third-degree frostbite (7.4%) also showed good outcomes after surgical reconstruction with a mean of 59 days healing time. In our clinical experiences of third-degree frostbite, definitive surgical reconstruction should be recommended to wait for more than 4~6 weeks for identification of clear demarcation of necrotic tissue caused by frostbite. In this study, 43 frostbite injuries site in 27 frostbite patients occurred. Among them, 15 patients (55.6%) had multiple-site frostbite injury. The most common predisposing cause of frostbite was refrigerant gas accidents (44.4%), followed by outdoor activity in cold environments (40.8%), misapplying ice pack for treatment purposes (7.4%), barefoot walking on the cold ground (3.7%), and loss of consciousness in cold grounds (3.7%). The most prevalent sites of frostbite injuries revealed as the hand (58.1%), followed by the foot (32.6%), face (7.0%), and abdomen (2.3%). And in the winter season from the November to March, the incidence rate of frostbite injuries was high at 74.1%. Conclusion: This study included 27 frostbite patients with 43 frostbite sites since last decade in a single institution at the community hospital. The frostbite patients with second-degree frostbite (92.6%) were successfully healed by the conservative treatment alone with a mean of 20.3 days healing time. The most common predisposing cause of frostbite was refrigerant gas accidents (44.4%), followed by outdoor activity in cold environments, etc. The most prevalent site of frostbite injuries was the hand (58.1%). And the most prevalent seasonal incidence of frostbite was from November to March (74.1%).

• The Korean Journal of Pain
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• v.9 no.1
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• pp.215-218
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• 1996

Frostbite involves freezing of tissues and usually affects the distal aspects of the extremities or exposed parts of the face. such as the ears, nose, chin, and cheeks. It produces tissue injury by ice crystal formation between the cells, cellular dehydration, and microvascular occulsion. There are four degrees of frostbite. First degree is accompanied by erythema and edema; second degree, by vesiculation, blistering, and eschar formation; third degree, by hemorrhagic blistering and bluish gray discoloration; and fourth degree, by injury to subcutaneous tissue, muscle, tendon, and bone leading to mottled, dry, black, and necrotic changes. We successfully treated 2 patients suffering from frostbite by performing sympathetic ganglion block with pure alcohol. We concluded sympathetic ganglion block is one of the most effective treatments for frostbite.

• Journal of Trauma and Injury
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• v.28 no.3
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• pp.158-169
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• 2015

Purpose: Frostbite can affect still soldiers. Initial clinical manifestations are similar for superficial and deep frostbite, so early treatment is identical. It is under-estimated by physicians. We try to identify the challenges of managing these complex tissue injuries. Methods: A retrospective analysis of 84 patients hospitalized at AFCH from 2009 to 2015 was conducted. We investigated differences of epidemiological characteristics, identification of soft tissue injury, treatment and complications between superficial (SF: 43; 51.2%) and deep (DF: 41; 48.8%) frostbite. Results: The major (94.0%) developed frostbite in dry circumstances (89.3%). Wet circumstances (66.7%) were more susceptible to DF rather than dry (46.7%). The 38 (45.2%) arrived to specialist within 7days. Most prone sites were feet, followed by hands. Toes had more deep injuries. DF presented more increased levels of ALT, CPK, CKMB, CRP. The bone scan of W+S+ was 48.3%, 87.1% and W+S- was 20.7%, 12.9%, respectively. The treatment resulted in improved or normalized perfusion scan with matching clinical improvement. It was a good tool to assess treatment response. Eighteen normal and 8 stenotic type of PCR resulted in normal with matching clinical improvement. One continuous obstructive waveform led to minor amputation. Twelve underwent both PCR and MRA. Among 6 normal PCR, 5 showed normal and one stenosis in MRA. All 5 stenosis and one obstruction showed the same findings in MRA. It was a good tool to evaluate vascular compromise. They were treated with rapid rewarming (11.6%, 22.0%), hydrotherapy (16.3%, 29.3%), respectively. Six (14.6%) underwent STSG, 2 (4.9%) had digital amputation in DF. Berasil, Ibuprofen, Trental were commonly administered. PGE1 was administered selectively for 6.8, 10.8 days, respectively. Raynaud's syndrome (16.3%), CRPS (4.7%), LOM (14.6%) and toe deformity (4.9%) were specific sequelae. Conclusion: We should recommend intensive foot care education, early rewarming and evacuation to specialized units. The bone scanning and PCR should allow for a more aggressive and active approach to the management of tissue viability.

• Archives of Plastic Surgery
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• v.40 no.5
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• pp.510-516
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• 2013

Background This paper discusses the treatment protocol for patients with frostbite. Methods We performed a retrospective analysis of a series of 17 patients with second- and higher-degree frostbite who had been treated at our medical institution between 2010 and 2012. Results Our clinical series of patients (n=17) included 13 men and four women, whose mean age was $42.4{\pm}11.6$ years (range, 22-67 years). The sites of injury include the foot in six patients (35.3%), the hand in six patients (35.3%) and the facial region in five patients (29.4%). Seven patients with second-degree frostbite were completely cured with only conservative treatment during a mean period of $12.7{\pm}3.3$ days (range, 8-16 days). Of the five patients with third-degree frostbite, two underwent skin grafting following debridement, and the remaining three achieved a complete cure with conservative treatment during a mean period of $35{\pm}4.3$ days (range, 29-39 days). Five patients with fourth-degree frostbite were treated with surgical procedures including amputation. Conclusions With the appropriate conservative management in the early stage of onset, surgeons should decide on surgery after waiting for a sufficient period of time until the demarcation of the wound. Continuous management of patients is also needed to achieve functional recovery after a complete cure has been achieved. This should also be accompanied by patient education for the avoidance of re-exposure to cold environments.

• Archives of Reconstructive Microsurgery
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• v.2 no.1
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• pp.70-76
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• 1993

The authors analyzed the clinical results of the reconstructive surgery for injured hands and feet due to frostbites and electrical burn with microsurgery in 7 patients, 12 cases at the department of orthopaedic surgery, school of medicine, Kyung Hee university from Jan. 1989 to Jul. 1992, and the results were as foollowings. 1. The age at the time of injury was av 24.6 yrs ranging from 4 to 35 yrs, and all cases were male. 2. The follow up period was av. 24.4 Mo ranging from 12 Mo. to 56 Mo. 3. The causes of injury were frostbite in 9 cases, electrical burn in 2 cases. 4. Initial operative treatment was performed av. 69.3 days ranging from 2 to 210 days. 5. For the reconstructive procedure, scapular free flap was applied in 6 cases, radial forearm flap in 4, dorsalis pedis 1ffap in 1, neurovascular island flap in 1. 6. Among total 12 cases, there were 5 cases(41.7%) of wound infection and 3 cases (25.0%) of partial necrosis of donor flap. 7. In 11 cases(90.1%), the end result was satisfactory. In the analysis of above results the reconstruction with microsurgery is effective procedure for reconstruction of Injured hand and foot due to frostbite and electrical burn.

• Proceedings of the Korean Institute of Navigation and Port Research Conference
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• 2015.10a
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• pp.141-143
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• 2015

최근 지구 온난화의 환경 변화에 극지 항로의 개척의 기회가 열렸다. 우리나라 선박은 극지항해 중 한랭손상의 경험이 매우 낮을 뿐만 아니라 열악한 선내의료 환경에서 손상 환자의 발생 시 정확한 응급처치는 어려울 수 있다. 한랭손상 중 저체온증과 동창, 동상에 대해 선내에서 정확한 환자평가와 응급처치를 위해서 국내 외의 응급처치 분야의 교육 자료를 조사하고 선내 한랭손상 응급처치의 기초 자료를 제공하기 위한 목적으로 수행하였다.

• Journal of Pharmacopuncture
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• v.16 no.2
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• pp.41-45
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• 2013

Objective: The root bark of Ulmus davidiana var. Japonica (Ulmi Radicis cortex, URC) is a medicinal herb used for promoting diuresis and treating dampness. In Korea, URC has long been used as an efficacious therapy for inflammation, burns, frostbite and skin diseases such as eczema and psoriasis. Methods: In the present study, we used 1-fluoro-2,4-dinitrofluorobenzene (DNFB)-induced contact dermatitis (CD) mouse model to investigate the anti-allergic and the anti-inflammatory effects of URC on skin lesion, histopathological changes and specific antibody production. Results: URC treatment, 10 mg/mL, effectively inhibited skin lesions induced by repeated paintings with DNFB. In the histopathological observation, topical application of URC inhibited spongiosis. In addition, URC lowered the production levels of total immunoglobulin and IgG2a in serum. Conclusion: These data indicate that URC has an anti-inflammatory effect that produces an improvement of skin lesions in CD mice.

• Journal of East-West Nursing Research
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• v.2 no.1
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• pp.37-53
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• 1997

The purpose is to inspect the personal medicines in Cheju island that are used traditionally and to get their characteristics. The subjectives are 39 Cheju people, men 10, women 29, who were horned, grown up in Cheju and agreed with this study. The ranges of age are 10 persons(m : 1, w: 9) over 40 less 50 years old, 14(m : 7, w : 7) over 50 less 60, 5(m : 1, w : 4) over 60 less 70, 6(m : 0, w : 6) over 70 less 80, and 4(m : 1, w : 3) over 80. The average age is 64.5 years old. The method to collect the data is 20 structured opening questionaires that are based on references. The duration to collect datas is 11days from 4th, Aprill 1997 to 14th, Aprill 1997. The workers who are trainned the interview methods went their villages and got answers after explaining the purpose and contents to them. Somtimes they used to record the answers. The analysis was identified the subjectives to four regions of Cheju, arranged answers with items, rearranged the same answers, counted with number and percentage. And classified the materials and characteristics. The results of this study are followed: The things that is used as personal medicines are the effects through experiences ans misteries that have hand down by word of mouth, even though they are not scientific. People used the materials arround their circumference. It is an accumulation of experiences. The ways used in eating, doing acupuncture or sting, exposing to smoke, wheedling, fixing after pounding. Almost materials are plants. Mugwort is effective in fever, gastritis, hemorrhoid, diarrhea, edematous hands or feet and dermatitis. Citron and Arrowroot in fever, gastritis. Seeds of Pumpkin in indigestive, hemorrhoid, edematous hands or feet. Gallic in fever, diarrhea, frostbite, dermatitis, and toothache. Motherwort in diarrhea, gastritis. Radish juice in indigestive, jaundice. Bean paste in burn, wound. Acupuncture in fever, gastritis, indigestive, back pain, edematous hands or feet. Sting as similar with it in fever, indigestive, edematous hands or feet. Cigarrette in hemorrhoid, wound, toothache. Cowstools in edematous hands or feet, wound. Sault is usded a lot in fever, gastritis, indigestive, hemorrhoid, uneffective voiding, edematous hands or feet, dermatitis, having a boil around the mouth, toothache, and eye disease. Japanese Parsley in fever, gastritis. Egg Apple in diarrhea, edematous hands or feet, frostbite. And Wild Chrysanthemum is effective in jaundice. In the conclusion, people used the things arround. A things is effective in several symptoms. If these are not effective, they would used the magic as god's anger. As locally, they used the grasses and fruits in the middle of Mt. Halla and seafood on the sea village.

• Journal of the Korean Institute of Oriental Medical Informatics
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• v.16 no.1
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• pp.105-133
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• 2010

Koreans has regarded a fair skin as the supreme beauty emphasizing the white beauty so long, and mugwort and garlic were used as whitening materials. Also, it was recorded that the people of Eub-Rue (挹婁) applied some lard to protect their skin from cold and prevent frostbite, and this must be a great way of beauty care in the light of modern sense. The basic beauty care materials currently used as skin care materials, include natural minerals like loess or mud, and the ones composed of a highly polymerized compound. However, by reason that they are produced without consideration of an individual skin condition, and rather bring about a number of problems leading to skin diseases. To complement this issue, using natural resources would have priority to make up for the weak points. For this, we decided to select and study "Dongeuibogam".

• The Korean Journal of Emergency Medical Services
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• v.21 no.2
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• pp.103-113
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• 2017

Purpose: The purpose of this study is to investigate the first aid knowledge and education requirements of physical therapists in a clinical setting. Methods: A self-reported questionnaire was distributed to 280 physical therapists in Daejeon, Gwangju, and Seoul from July to December, 2016. Using only completed questionnaires, 201 responses were analyzed using IBM SPSS 23.0 program. Results: In the first aid knowledge, time to resuscitate heart after cardiac arrest and sprain had 91.0% and 99.0%, respectively, whereas partial respiratory obstruction and diabetes mellitus had 25.4% and 18.9%, respectively. The subjects working at advanced general hospitals(62.17) had significantly higher scores that those at general hospitals(53.82). The subjects who experienced first aid education(59.16) had significantly higher points that those without first aid education(53.24). Regarding their requirements of first aid education, 64.0% replied that they wanted to learn cardiopulmonary resuscitation and automated external defibrillator, poisoning, burn, and frostbite were low educational requirements. Conclusion: It is necessary to provide repeated first aid training that helps physical therapists in the field have sufficient first aid knowledge and increase that knowledge over time.