This is a report on 39 patients (from 36 to 84 years of age) with acute ischemic gangrene of the lower limbs and severe concomitant diseases (ischemic heart disease, arterial hypertension, diabetes mellitus, etc.). Cooling of the necrotic limb with the application of a tourniquet and general nonoperative treatment were conducted in preparation for amputation. Cooling was accomplished with dry ice and common ice in 16 patients and with a special refrigerator in 23 patients. Six patients whose condition was very grave died during refrigeration. Amputation of the lower limb was performed in 33 patient, 26 of them tolerated the operation favourably. Wound complications were encountered in 9 patients.
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