Classification of Cauchy et al for Frostbite Lesions

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Release 22.0, Sept. 2008

The Medical Algorithms Project

Chapter :

ch34. Environmental Health

Section :

Low Environmental Temperatures

Classification of Cauchy et al for Frostbite Lesions

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Reference

Overview :

Cauchy et al proposed a new classification of frostbite lesions involving the extremities. Findings after initial rewarming and on day 2 after admission may be helpful in management planning. The authors are from Chamonix, France.

Parameters:

(1) initial lesion on day 0 after rapid rewarming

(2) radiotracer uptake in bone scan on day 2

(3) skin blisters on day 2

Initial Lesion	Radiotracer Uptake on Bone Scan	Skin Blisters	Grade
none	not indicated	none	1
on distal phalanx	hypofixation of radiotracer	clear fluid	2
on middle phalanx, may involve proximal	absence of uptake on digits	hemorrhagic, on digit	3
carpal or tarsal	absence of uptake on carpal/tarsal	hemorrhagic, over carpal/tarsal	4

Grade	Outcome
1	no amputation and no long term sequelae
2	some tissue amputation with fingernail sequelae
3	bone amputation in digit; functional sequelae
4	more extensive amputation; may suffer thrombosis; may become septic; may have systemic illness; functional sequelae

References:

Cauchy E, Chetaille E, et al. Retrospective study of 70 cases of severe frostbite lesions: a proposed new classification scheme. Wilderness and Environmental Medicine. 2001; 12: 248-255.

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