[at-l] Somewhat OT Help Needed

[KarenS62@aol.com (KarenS62@aol.com)]

In a message dated 3/16/2001 4:23:03 PM Eastern Standard Time,=20
thornel@attglobal.net writes:


>  It will autoamputate, is devoid of sensation (including pain). There are=20
> risks of infection in the neighboring tissues that are injured and=20
>=20


Seems to me that leaving the necrotic (dead and black) tissue on the toe=20
would actually add a layer of insulation, at least area it is connected to=20
the live tissue.  Assuming its the black, crunckhy type of frostbite.=20

Now...if I remember correctly, there are usually two types of gangrene based=
=20
on the mechamism originally causing the frostbite.  The first one (I think=20
its usually called dry) is from extreme cold and usually affects deep tissue=
.=20
The "dry" gangrene is usually limited to the affected area and infection=20
doesn't spread. This is the black one often seen on mountain climbers. They=20
sometimes eventually amputate these parts to prevent further injury to the=20
attached live tissue but that occurs after the scabs have fallen off.=20

The second one (which I assume is called wet) is a result of extended=20
exposure to freezing water and can spread infection quite easily - requiring=
=20
amputation to prevent death.  A specific patient I remember involved a=20
paramedic who was at the scene of a multi-vehicle accident for several hours=
=20
during an ice storm. His socks got wet and wicked the moisture into his=20
boots. When he finally removed his boots many hours later, his toes were=20
white, clammy, swollen and tender to touch. He developed an infection and=20
eventually needed to have is big toe amputated as the infection started to=20
spread up his foot.

Just one more reason to change socks often or wear vapor barriers when hikin=
g=20
in wet deep snow.=20

POG

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"I was always looking outside myself for strength and confidence,
but it comes from within.=A0 It is there all the time."     Anna Freud




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