Sınır bölgelerinde zorunlu hareket halindeki popülasyonlarda ekstremite donmalarının klinik seyri ve tedavisi Clinical course and management of extremity frostbite in populations under forced movement in border regions

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Binici S., Aslan F., Beger B., Beger O., Mengi S., Karayil A. R., ...Daha Fazla

Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES, cilt.32, sa.10, ss.1278-1288, 2026 (Scopus)

Özet

BACKGROUND: Frostbite is a serious cold injury that can progress to deep tissue damage and even amputation. The increasing number of cases among refugee and migrant populations who are forcibly mobile in border regions necessitates a detailed evaluation of clinical course and risk factors. This study aimed to assess the demographic characteristics, clinical course, laboratory findings, and treatment outcomes of patients presenting with frostbite-related extremity injuries. METHODS: This retrospective study included a total of 154 patients who presented with a clinically confirmed diagnosis of frostbite. Patients were analyzed according to three predefined classifications: treatment approach (conservative, medical, advanced/interventional), anatomical distribution of frostbite involvement, and time to hospital presentation (≤12 h, 12-24 h, 24-36 h, 36-48 h, and >48 h). Demographic data, clinical findings, laboratory parameters, treatment modalities, and clinical outcomes were evaluated. Statistical analyses were performed using non-parametric tests and Chi-square analysis. RESULTS: The median age of the patients was 23 years, and 94.2% were foreign nationals. The most common time to presentation was 12-24 h after cold exposure (61%). As the time to hospital admission increased, frostbite grade, number of affected extremities, frequency of hypotension, white blood cell (WBC) levels, and length of hospital stay increased significantly (p<0.001). Amputation was performed in 77.3% of patients, and all amputated cases had fourth-grade frostbite. Amputation was significantly associated with delayed presentation, hypotension, elevated WBC levels, larger frostbite area, and longer hospital stay (p<0.05). CONCLUSION: Delayed presentation and severe systemic involvement are the most important determinants of amputation risk. Early diagnosis, rapid and controlled rewarming, appropriate patient transfer, and timely access to advanced treatment options are critical for reducing amputation rates.