Contribution of Dr. William J. Mills to the treatment of frostbite

Abstract

Dr. William J Mills Jr., an Alaskan orthopedic surgeon, helped establish the protocol for the treatment of frostbite and changed a dogma used for more than 140 years that was offered by Napoleon’s Surgeon General of the Army, Baron Dominique-Jean Larrey. During Napoleon’s 1812 siege of Moscow, in which one of the most disastrous frostbite epidemics happened, Larrey noticed the destructive effects of using open fire heat for warming frozen body parts, so he suggested rubbing snow or immersion in the cold water. Dr. Mills had an interest in cold injuries and frostbite during his medical career. After setting up his medical practice in Anchorage, Alaska, he realized the inefficiency of current treatments and started researching the treatment of frostbite. Dr. Mills followed Meryman’s method of thawing frozen red blood cells by immersion in warm water. Mills and his colleagues established a treatment protocol for freezing cold injury that included rapid warming of frozen tissues in warm water. These studies resulted in the publication of three papers in 1960 and 1961. These papers were the first clinical studies that described rapid warming as a treatment. Subsequently, rapid warming, with some variation in water temperatures, has been accepted as the standard of treatment universally. Due to his outstanding contribution to the treatment of frostbite, he has been referred to as North America's leading authority on cold injuries. Mills and his colleagues created a new classification system that divided frostbite into two levels, superficial and deep, which was more applicable in clinics instead of the traditional 4-tier classification. The 2-tier classification is still useful outside of the hospital setting.