COLD INJURIES IN KOREA DURING WINTER OF 1950–51

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Abstract
Cold injuries include frostbite (ground type and high altitude frostbite) and the trench foot-immersion foot syndrome. Under combat conditions, a mixture of trench foot and frostbite is common. By the time the patients were seen, the affected part had generally been rewarmed, and it was difficult to determine whether actual freezing of the tissues had taken place. The records of 2257 cases admitted to a special Army hospital serving as a center for cold injuries are reviewed. Frostbite is classified into 4 degrees of severity, and all degrees may be present in a part, the distal portion being most severely injured. The sites of injury are generally the extremities, chiefly the feet. There was no significant difference incidence of frostbite between smokers and nonsmokers. The incidence was higher among Negro troops than white troops. The physiopathology of frostbite is not entirely clear, but it is certain that there is an important vascular component. During the chilling period peripheral vasoconstricrtion is present. After rewarming, hyperemia occurs, and the part becomes edematous and vesicles and bullae appear. Thrombosis may occur, with resulting gangrene which may be dry or wet (secondarily infected). The clinical manifestations depend upon severity of injury and early management. The onset of freezing is not particularly painful and is associated chiefly with numbness. After rewarming, swelling begins in less than 3 hrs., and vesiculation within the next day. Immediately after rewarming even the most severely injured parts became warm. Treatment is descr.
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