Frostbite—A Case Series From Arctic Greenland

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Presentation transcript:

Frostbite—A Case Series From Arctic Greenland Anne K. Lorentzen, MD, Luit Penninga, MD, PhD Wilderness & Environmental Medicine Volume 29, Issue 3, Pages 392-400 (September 2018) DOI: 10.1016/j.wem.2018.03.001 Copyright © 2018 Wilderness Medical Society Terms and Conditions

Figure 1 Map of Greenland. More than two thirds of Greenland’s landmass is covered by a permanent ice sheet. Around 17,000 of Greenland’s 57,000 inhabitants live in the capital city Nuuk. The other major cities are Sisimiut (5500 inhabitants), Ilulissat (4500 inhabitants), Qaqortoq (3500 inhabitants), Aasiaat (3000 inhabitants), and Qaanaaq (600 inhabitants), which is the most northern city in Greenland. Wilderness & Environmental Medicine 2018 29, 392-400DOI: (10.1016/j.wem.2018.03.001) Copyright © 2018 Wilderness Medical Society Terms and Conditions

Figure 2 Case 1—Single digit frostbite, fisherman, Ilulissat. A, B, Frostbitten area at 2 wk postinjury. C, Digit at 6 wk postinjury. Wilderness & Environmental Medicine 2018 29, 392-400DOI: (10.1016/j.wem.2018.03.001) Copyright © 2018 Wilderness Medical Society Terms and Conditions

Figure 3 Case 2—Frostbite on footsole, Ilulissat Hospital A, Frostbite lesion 10 d postinjury. B, 10 wk later, there are no visible sequelae, and none reported by the patient. Wilderness & Environmental Medicine 2018 29, 392-400DOI: (10.1016/j.wem.2018.03.001) Copyright © 2018 Wilderness Medical Society Terms and Conditions

Figure 4 Case 3—Multiple toe frostbite, Northern Greenland expedition. A, B, Fourth-degree frostbite injuries on the distal phalanx of the left first to third toe 3 mo postinjury. The toes are dry and necrotic with a clear demarcation line. C, Right forefoot, on which necrosis is only present on the tip of the most medial toes. Wilderness & Environmental Medicine 2018 29, 392-400DOI: (10.1016/j.wem.2018.03.001) Copyright © 2018 Wilderness Medical Society Terms and Conditions

Figure 5 Case 4—A, B, Bilateral cheek frostbite during Arctic storm, Qaanaaq. First-degree frostbite on both cheeks, 4 d after the Arctic storm during which the frostbite injuries arose. C, At follow-up 5 mo later, no tissue loss had occurred. Wilderness & Environmental Medicine 2018 29, 392-400DOI: (10.1016/j.wem.2018.03.001) Copyright © 2018 Wilderness Medical Society Terms and Conditions

Figure 6 Case 5—Frostbite on both hands during Arctic storm, Qaanaaq. Second- or third-degree frostbite on both hands, with edema and multiple bullae filled with clear fluid on day 1. The patient was treated conservatively with a silver sulfadiazine ointment and wound dressings daily for 21 d. He experienced no tissue loss but had significant cold hypersensitivity after 6 mo. Note the slight discoloration of the nails as the only objective finding at 6 mo follow-up. Wilderness & Environmental Medicine 2018 29, 392-400DOI: (10.1016/j.wem.2018.03.001) Copyright © 2018 Wilderness Medical Society Terms and Conditions

Figure 7 Case 6—Single digit frostbite, Qaanaaq. A, B, Fourth-degree frostbite injury at 3 mo after the initial injury. The necrotic distal phalanx is clearly demarcated. C, Two weeks later there was edema and purulent discharge from the wound, indicating infection, and surgical amputation was performed. Wilderness & Environmental Medicine 2018 29, 392-400DOI: (10.1016/j.wem.2018.03.001) Copyright © 2018 Wilderness Medical Society Terms and Conditions