The Planica Protocol for Frostbite Management - 3 Case Reports

Gorjanc J1,2*, Mekjavič IB3,4, Mekjavič PJ5 and Schneider B6

1Hospital Krankenhaus of the Elisabethinen, Day Clinic, Austria
2Mountain Rescue Association of Slovenia, Slovenia
3Department of Automation, Biocybernetics and Robotics, Jožef Stefan Institute, Slovenia
4Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Canada
5University Clinical Centre, Eye Clinic, Slovenia
6Gesamtschule Kürten, Kürten, Germany

^*Correspondance to: Jurij Gorjanc 

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Abstract:

Frostbite is a consequence of tissue freezing. Deep frostbite injury without proper treatment results in tissue loss. The damage is mainly a consequence of irreversibly damaged vascular endothelium and vascular occlusion and partly a direct effect of cold on peripheral body areas. Amputations in hands have a strong impact on functional impairment and leave behind permanently disabled patients. Different diagnostic and therapeutic protocols for frostbite management have been developed and are implemented nowadays. The Planica protocol for frostbite management has evolved from our own research in years of clinical practice. It emphasizes frostbite as emergency condition. Three cases of alpinists are presented, who suffered frostbite on different mountains and altitudes. After hospital admission, all three alpinists were treated according to the Planica diagnostic and therapeutic algorithm for frostbite management (medication with iloprost, pentoxifylline, enoxaparin, ibuprofen, pantoprazole, amoxicillin/clavulanic acid). Additionally, management with Hyperbaric Oxygen therapy (HBO) was administered. In all patients, the preserved length of injured digits was larger, as it had been estimated at the admission and at the bone scans. Additionally, to the proper first aid and prompt emergency medical assistance, the Planica protocol for frostbite management consists of standardized hospital treatment, which is the key for a favorable outcome (without tissue loss).

Keywords:

Frostbite; Freezing cold injury; Amputations; Hyperbaric oxygen treatment

Cite the Article:

Gorjanc J, Mekjavič IB, Mekjavič PJ, Schneider B. The Planica Protocol for Frostbite Management - 3 Case Reports. Ann Clin Case Rep. 2023; 8: 2469.