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Medical Education Division |
Operational Medicine 2001
Second United States Revision of The Emergency War Surgery NATO
Handbook
United States Department of Defense
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Emergency War Surgery NATO Handbook: Part I: Types of Wounds and Injuries: Chapter IV: Cold Injury Pathologic ProcessUnited States Department of Defense Although a number of physiologic changes induced by cold may explain tissue loss, it is doubtful that they all play a significant part in clinical cold injury. Intracellular molecular changes due to hyperosmolarity, direct metabolic impairment secondary to the cold, and cellular structural damage from the mechanical effect of ice crystals seem far less important than impairment of nutritional blood flow as a final determinant of tissue injury after thawing. Vascular stasis following thaw from freezing injury has been well documented. Clinical and experimental data indicate the importance of capillary blood flow as the determinant of reversibility in tissue freezing. Alterations in capillary permeability are evident from experimental data and, clinically, from the edema and bleb formation that occur soon after thawing. Endothelial disruption may be responsible for the progressive capillary stasis, plugging, and thrombosis that eventually occur.
Approved for public release; Distribution is unlimited. The listing of any non-Federal product in this CD is not an endorsement of the product itself, but simply an acknowledgement of the source. Operational Medicine 2001 Health Care in Military Settings
This web version is provided by The Brookside Associates Medical Education Division. It contains original contents from the official US Navy NAVMED P-5139, but has been reformatted for web access and includes advertising and links that were not present in the original version. This web version has not been approved by the Department of the Navy or the Department of Defense. The presence of any advertising on these pages does not constitute an endorsement of that product or service by either the US Department of Defense or the Brookside Associates. The Brookside Associates is a private organization, not affiliated with the United States Department of Defense. |