Frostbite injury treatment in Vilnius in 2000–2005

Objectives Analysis of the population, methods of treatment and treatment results of patients treated due to frostbite injury in Vilnius University Hospital in 2000–2005. Comparison of results with data published in the medical literature. Patients and methods A retrospective analysis of 129 medical records of patients treated due to frostbite injury in the Vilnius city University Hospital, patient’s age at the time of frostbite, gender, diagnosis, social status, alcohol abuse at the time of frostbite injury were analysed, as well as the mean time from frostbite injury until addmission to the hospital, the time from addmission until operative treatment, the type of surgical treatment, the time from surgery until outpatient treatment, complications of surgical wounds, total hospitalization time, treatment outcome, annual of frostbite injuries frequency were investigated. Results Medical records of 129 patient were analysed. Gender: 109 (84.5%) male, 20 (15.5%) female patients. Mean age: 46.16 years. Diagnosis: ankle and foot frostbite with tissue necrosis (n = 97), superficial frostbite of ankle and foot (n = 12), frostbite of wrist and hand with tissue necrosis (n = 9), superficial frostbite of wrist and hand (n = 11). Social status: homeless 53 (41.08%), unemployed 33 (25.58%), employed 12 (9.30%), disabled individuals 10 (7.75%), pensioneers 19 (14.73%), students and school-aged 2 (1.55%). Alcohol abuse at the time of frostbite injury: positive 67 (51.94%), negative 14 (10.85%), presented late and did not remember or did not declare 48 (37.21%). The time from injury until presentation 9.7 days (0–58), from addmission until operation 6,03 days (0–27). Major amputations of limbs 23 (25.55%), minor amputations 67 (74.44%), total surgery 90 (69.77%), emergency treatment followed by conservative treatment with only superficial necrotic tissue debridement or exited 39 (30.23%). Hospitalization from operation until discharge 27.73 days (1–96). Postoperative wound complications: per secundam intentionem healing n = 89 (98.89%), foot phlegmona n = 1 (1.11%). The total mean hospitalization time 28.61 days (1–117). Sixteen patients died (acute cardiopulmonary insufficiency due to total body freezing), 14 patients were provided with disabled status during hospitalization, 106 were discharged for the outpatient treatment, 2 patients withdrew at own will, 7 patients were transferred to rehabilitation hospitals. Conclusions As the results suggest, men on average 46.16 years old, mostly homeless, were treated. Most of them used alcohol before frostbite injury. Presentation to the hospital was late. The most frequent sites affected by frostbite were the foot and the ankle with tissue necrosis. The total mean time of inpatient treatment was long. Rendering the disabled status was complicated due to the specific social behaviour of patients and a long personal identification