Long-Term Sequelae of Frostbite—A Scoping Review

Ivo B. Regli, Giacomo Strapazzon, Marika Falla, Rosmarie Oberhammer and Hermann Brugger
Additional contact information
Ivo B. Regli: Institute of Mountain Emergency Medicine, Eurac Research, 39100 Bolzano, Italy
Giacomo Strapazzon: Institute of Mountain Emergency Medicine, Eurac Research, 39100 Bolzano, Italy
Marika Falla: Institute of Mountain Emergency Medicine, Eurac Research, 39100 Bolzano, Italy
Rosmarie Oberhammer: Department of Anaesthesia and Intensive Care, Hospital of Brunico, 39031 Brunico, Italy
Hermann Brugger: Institute of Mountain Emergency Medicine, Eurac Research, 39100 Bolzano, Italy

IJERPH, 2021, vol. 18, issue 18, 1-16

Abstract: 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.

Keywords: frostbite; cold injury; pathophysiology; neuropathic pain; nociceptive pain; arthritis; vasospasm (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

Downloads: (external link)
https://www.mdpi.com/1660-4601/18/18/9655/pdf (application/pdf)
https://www.mdpi.com/1660-4601/18/18/9655/ (text/html)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:gam:jijerp:v:18:y:2021:i:18:p:9655-:d:634820

Access Statistics for this article

IJERPH is currently edited by Ms. Jenna Liu

More articles in IJERPH from MDPI
Bibliographic data for series maintained by MDPI Indexing Manager ().