Frostbite: Current status and advancements in therapeutics

Joshi, Kumud; Goyary, Danswrang; Mazumder, Bhaskar; Chattopadhyay, Pronobesh; Chakraborty, Reshmi; Bhutia, Yangchen Doma; Karmakar, Sanjeev; Dwivedi, Sanjai K.

doi:10.1016/j.jtherbio.2020.102716

Cited by 34 publications

(29 citation statements)

References 56 publications

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“…To combat this challenge, a wide array of imaging techniques, including plain radiography (X-ray), laser and ultrasound Doppler, angiography, multiphase bone scintigraphy (bone scans), and single-photon emission computed tomography fused with conventional computed tomography (SPECT/CT), have been used to precisely define the severity, depth, and extent of injury. 14 , 21 , 22 ( See figure, Supplemental Digital Content 2, which summarizes radiographic imaging techniques used in frostbite management. http://links.lww.com/PRSGO/C223 .)…”

Section: Resultsmentioning

confidence: 99%

“…Several studies have demonstrated improved digital salvage rates in patients when vessel compromise is identified by digital subtraction angiography and subsequently treated with thrombolytics within 48 hours of injury. 21 , 14 , 22 While protocols for thrombolytics vary between institutions, if thrombolytics are administered, angiography should be repeated every 12–24 hours to monitor treatment response. 23 , 24 However, angiography should be selectively used in patients prone to or with a history of renal disease given the need for contrast dye load.…”

Section: Resultsmentioning

confidence: 99%

“…According to Kraft et al, SPECT/CT is superior to bone scan alone, because this hybrid system provides increased anatomic precision and identifies areas of decreased signal uptake that is essential for surgical planning. 14 , 22 , 25 …”

Section: Resultsmentioning

confidence: 99%

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Practical Review of the Current Management of Frostbite Injuries

Zaramo

Green

Janis

2022

Plastic and Reconstructive Surgery - Global Open

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Summary: Frostbite is an injury that occurs when the skin and tissues are exposed to temperatures below their freezing point. This type of injury can lead to various complications such as functional loss, chronic pain, and psychological trauma. As such, understanding frostbite management is crucial for optimal patient care. A scoping review was conducted in February 2022 using PubMed, EMBASE, referenced articles and snowballing to identify relevant published articled using the terms “frostbite” and “management” and “surgery. Articles related to pathophysiology, classifications, radiography, complications, and medical and surgical management were included to formulate recommendations for practical management. Two hundred fifty-one articles were identified and 54 met inclusion criteria. Rapid rewarming in warm water (40-42 °C) remains the standard of care. Thrombolytic therapy has been shown in numerous studies to improve tissue salvage. Radiographic imaging has become crucial in the evaluation and management in frostbite injury. Current literature recommends delayed surgery with soft tissue debridement and bone scan-guided amputations. Surgical intervention including debridement, selective blister drainage, fasciotomies, surgical salvage, skin grafts‚ and flaps are often necessary in these patients towards optimizing form and function. The true prevalence and incidence of frostbite injury is unknown. A centralized national database will improve our understanding of the diagnostic and management modalities used in frostbite care. Plastic surgeons have a critical role in the management of frostbite care and must work with an interdisciplinary team to identify the best treatment route for optimal patient care.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Practical Review of the Current Management of Frostbite Injuries

Zaramo

Green

Janis

2022

Plastic and Reconstructive Surgery - Global Open

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“…44,45 Because frostbite may cause serious complications such as amputation and sepsis, the early treatment of frostbite wound has been widely concerned. 46 For decades, sulfadiazine, as an antibiotic, has been used for wound healing such as burns and frostbite. Some articles have also proved that electrospun polylactic acid material also has a certain antibacterial effect.…”

Section: Discussionmentioning

confidence: 99%

Electrospun polylactic acid/sulfadiazine sodium/proteinase nanofibers and their applications in treating frostbite

Ding

Zhou

Fan

et al. 2021

J of Applied Polymer Sci

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In this study, polylactic acid (PLA)/sulfadiazine sodium/proteinase K composite nanofibers were prepared by electrospinning, and their morphology was observed by scanning electron microscope. The novel nanofibers were characterized by Fourier transform infrared spectroscopy and drug release curve. The activity of different groups of drugs loaded nanofibers in frostbite wound of rats was studied and compared with the blank control group. Hematoxylin-eosin staining and transmission electron microscope were used to access the histological changes of frostbite wounds on the back of rats before and after treatment.CD31 fluorescence staining was used to track the reconstruction and improvement of blood vessels in tissues. The results revealed that the drug release rate of PLA/sulfadiazine sodium/proteinase K nanofibers group was more than 50% at 1 h, and the cumulative drug release rate was more than 88% at 168 h, and CD31 fluorescence showed that its vascular density was 13.27% ± 0.9%, which was significantly higher than that of other groups. Therefore, PLA/sulfadiazine sodium/proteinase K composite nanofibers could promote the healing of frostbite wounds, which indicated the increase of capillaries and the regeneration of hair follicles. PLA/sulfadiazine sodium/proteinase K composite nanofibers have great potential in the application of frostbite.

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“…In the early 19th century, Dr. Dominique Jean Larrey, Napoleon Bonaparte's Surgeon-in-Chief, wrote the first systematic report on frostbite injuries and their treatment [7]. In World War II, allied forces recorded 91,000 cases of frostbite, while German troops reported 46,000 cases [8].…”

Section: Epidemiologymentioning

confidence: 99%

Long-Term Sequelae of Frostbite—A Scoping Review

Regli

Strapazzon

Falla

et al. 2021

IJERPH

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Frostbite is tissue damage caused by freezing temperatures and constitutes an important cause of morbidity in cold climate zones and high altitude. The direct effects of sub-zero temperatures lead to tissue freezing, electrolyte shifts and pH alterations, microvascular damage, and eventually to cell death. Upon rewarming, inflammatory reperfusion injury and thrombosis may lead to further tissue damage. Several studies and various case reports show that many patients suffer from long-term sequelae such as vasomotor disturbances (associated with susceptibility to refreezing), and neuropathic and nociceptive pain, as well as damage to skeletal structures. There are still many uncertainties regarding the pathophysiology of these sequelae. It has been shown that the transient receptor potential channel (TRP) family plays a role in cold allodynia. Botulinum Toxin type A (BTX-A) injections have been reported to be beneficial in vasomotor and neuropathic disturbances secondary to frostbite. Epidural sympathetic block has been used for short-term treatment of frostbite induced chronic pain. Furthermore, amitriptyline, gabapentinoids, and duloxetine may have some benefits. Frostbite arthritis clinically resembles regular osteoarthritis. In children there is a risk of epiphyseal cartilage damage leading to bone deformities. Despite some promising therapeutic concepts, the scarcity of data on frostbite long-term sequelae in the literature indicates the need of more in-depth studies of this pathology in all its aspects.

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Frostbite: Current status and advancements in therapeutics

Cited by 34 publications

References 56 publications

Practical Review of the Current Management of Frostbite Injuries

Practical Review of the Current Management of Frostbite Injuries

Electrospun polylactic acid/sulfadiazine sodium/proteinase nanofibers and their applications in treating frostbite

Long-Term Sequelae of Frostbite—A Scoping Review

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