Frostbite

In Reply.— Rowlingson and Carron suggest consideration of transcutaneous electrical nerve stimulation (TENS) in the management of frostbite. As they mentioned, sympathetic blocks have been effective in the management of early frostbite; blood flow increase has resulted in the salvage of damaged digits. Interarterial reserpine and prostacycline also have been shown to overcome digital vasoconstriction. In the two patients we described, persistent vasoconstriction as seen in reflex sympathetic dystrophy (RSD) was not the problem. Moreover, the changes seen in the radiographs were not comparable to those seen in RSD.