Abstract
This paper comprises a critical analysis of the literature on refrigeration anesthesia for amputations based on personal experience. To the 101 cases reported by Allen, Crossman and others1we add observations on 17 cases of our own, eight amputations for peripheral vascular disease and nine amputations for trauma. What is meant by refrigeration? It is the chilling of tissues. It is not freezing. Freezing damages tissues as in frostbite; refrigeration does not. Water freezes at 0 C. (32 F.). Blood and tissues freeze at a slightly lower level. Refrigerating a limb with cracked ice or ice water lowers the temperature to somewhere between 0.5 and 5 above freezing. With a mechanical device the exact degree of refrigeration may be controlled. Hence there is a definite margin of safety. In no instance have we seen the tissues damaged. In an effort to determine the exact temperatures deep in the tissues
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