Frostbite – From Turkish Eastern Border As A Consequence Of Irregular Migration
Frostbite – From Turkish Eastern Border As A Consequence Of Irregular Migration
Frostbite is becoming more prevalent within the homeless, mentally ill and substance abusing subgroup. However; our objective is to evaluate the clinical presentation, treatment and consequences of frostbite seen in a different population– irregular migrants captured at Eastern Border of Turkey. In addition, up to date approach to frostbite injury is reviewed. Data extraction was done retrospectively from 40 patients’ admission to hospital from 26 January till 25 February 2020. Each patient was assigned with the grade of the most severe frostbite lesion detected at the admission. Clinical pictures were captured for the follow up of demarcation at each dressing change. Multidisciplinary treatment modality was summarized. 38 patients were included. Within the population dominated mainly by male young adults, 74% of the patients presented with Grade 3-4 severity whereas 26% were assigned with Grade 1-2 frostbites. Majority of the frostbitten areas were confined to lower extremities. Assigned frostbite gradings at the admission didn’t deflect within the hospitalization period apart from 3 patients worsening towards grade 4 following fasciotomy. Frostbite injury has detrimental outcomes if not recognized and treated in a timely manner. If not, the likelihood of receiving amputations significantly increase.
___
- 1- Gross EA, Moore JC. Using thrombolytics in frostbite injury. J Emerg Trauma Shock. 2012;5(3):267-271. doi:10.4103/0974-2700.99709
- 2- Peck MD. Epidemiology of burns throughout the world. Part I: Distribution and risk factors. Burns. 2011;37(7):1087-1100. doi:10.1016/j.burns.2011.06.005
- 3- Smolle C, Cambiaso-Daniel J, Forbes AA, et al. Recent trends in burn epidemiology worldwide: A systematic review. Burns. 2017;43(2):249-257. doi:10.1016/j.burns.2016.08.013
- 4- Heil KM, Oakley EH, Wood AM. British Military freezing cold injuries: a 13-year review. J R Army Med Corps. 2016;162(6):413-418. doi:10.1136/jramc-2015-000445
- 5- DeGroot DW, Castellani JW, Williams JO, Amoroso PJ. Epidemiology of U.S. Army cold weather injuries, 1980-1999. Aviat Space Environ Med. 2003;74(5):564-570.
- 6- Shenaq DS, Gottlieb LJ. Cold Injuries. Hand Clin. 2017;33(2):257-267. doi:10.1016/j.hcl.2016.12.003
- 7- Nizamoglu, M., Tan, A., Vickers, T. et al. Cold burn injuries in the UK: the 11-year experience of a tertiary burns centre. Burn Trauma 4, 36 (2016). https://doi.org/10.1186/s41038-016-0060-x
- 8- McLeron, K. Frostbite. In: State of Alaska - Cold Injury Guidelines. Department of Health and Social Services Division of Public Health. 2003.https://www.umanitoba.ca/faculties/kinrec/hlhpri/media/AlaskaColdGuidelines0 5.pdf. Accessed July 2020. 11
- 9- UNODC. Smuggling of migrants: A Global Review and Annotated Bibliography of Recent Publications. 2011.http://www.unodc.org/documents/humantrafficking/MigrantSmuggling/Smuggli ng_of_Migrants_A_Global_Review.pdf. Accessed July 2020.
- 10- Shenaq DS, Beederman M, O'Connor A, Teele M, Robinson MR, Gottlieb LJ. Urban Frostbite: Strategies for Limb Salvage. J Burn Care Res. 2019;40(5):613-619. doi:10.1093/jbcr/irz062
- 11- Zafren K. Frostbite: prevention and initial management. High Alt Med Biol. 2013;14(1):9-12. doi:10.1089/ham.2012.1114
- 12- WASHBURN B. Frostbite: what it is--how to prevent it--emergency treatment. N Engl J Med. 1962;266:974-989. doi:10.1056/NEJM196205102661905
- 13- Danzl, DF, Zafren K. Frostbite. In J. A. Marx, Editor. Rosen’s Emergency Medicine: Concepts and Clinical Practice. (8th ed). Philadelphia: Elsevier; 2014. pp. 1877-1882
- 14- Malhotra MS, Mathew L. Effect of rewarming at various water bath temperatures in experimental frostbite. Aviat Space Environ Med. 1978;49(7):874-876.
- 15- Heggers JP, Robson MC, Manavalen K, et al. Experimental and clinical observations on frostbite. Ann Emerg Med. 1987;16(9):1056-1062. doi:10.1016/s0196-0644(87)80758-8
- 16- Poole A, Gauthier J. Treatment of severe frostbite with iloprost in northern Canada. CMAJ. 2016;188(17-18):1255-1258. doi:10.1503/cmaj.151252
- 17- Bruen KJ, Ballard JR, Morris SE, Cochran A, Edelman LS, Saffle JR. Reduction of the incidence of amputation in frostbite injury with thrombolytic therapy. Arch Surg. 2007;142(6):546-553. doi:10.1001/archsurg.142.6.546
- 18- Kemper TC, de Jong VM, Anema HA, van den Brink A, van Hulst RA. Frostbite of both first digits of the foot treated with delayed hyperbaric oxygen:a case report and review of literature. Undersea Hyperb Med. 2014;41(1):65-70.
- 19- Dwivedi DA, Alasinga S, Singhal S, Malhotra VK, Kotwal A. Successful treatment of frostbite with hyperbaric oxygen treatment. Indian J Occup Environ Med. 2015;19(2):121-122. doi:10.4103/0019-5278.165336
- 20- Khan MI, Tariq M, Rehman A, Zafar A, Sheen SN. Efficacy of cervicothoracic sympathectomy versus conservative management in patients suffering from incapacitating Raynaud's syndrome after frost bite. J Ayub Med Coll Abbottabad. 2008;20(2):21-24.