Effect of freezing and thawing on the microcirculation and capillary endothelium of the hamster cheek pouch

Golden Syrian hamster cheek pouches were prepared in vivo for observation of microvasculature under the light microscope. On an apparatus designed especially for this purpose, pouches were cooled from plus 10 °C to minus 30 °C at 1 °C/min, held at minus 30 °C for 1 min and warmed at 1 °C/min to plus 10 °C whence spontaneous rewarming to ambient was permitted. Pouches were observed under the light microscope throughout freezing and for 1 hr after thaw. At 0, 1, 5, 15, 30, and 60 min after thaw pouch tissue was taken for electron microscopy. After thaw hemostasis evolved in a biphasic pattern. In the early phase in which the degree of stasis reached its peak at about 20 min after thaw, cessation of circulation was caused by obstructive embolic platelet aggregates and a second uncharacterized factor, possibly humoral in nature. After 30 min, blood flow spontaneously resumed in at least one portion of each pouch. In 6 specimens, by 45–50 min, blood flow had returned to normal in about 90% of the microvasculature. After 50 min hemostasis began again and by 60 min blood flow had ceased in virtually all areas of the pouch, this time in the absence of vascular obstruction by platelet aggregates. Ultrastructural damage to endothelial cells occurring immediately at thaw and progressing through 1 hr thereafter included the rupture of cell membranes, early thinning, and later condensation of ground substance, decrease in the number and concentration of pinocytotic vesicles, swelling of rough endoplasmic reticulum, and the swelling and loss of cristal structure of mitochondria. This endothelial destruction can account for the permanent hemostasis of frostbite.