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Long-Term Sequelae of Frostbite—A Scoping Review

Author

Listed:
  • Ivo B. Regli

    (Institute of Mountain Emergency Medicine, Eurac Research, 39100 Bolzano, Italy
    Department of Anaesthesia and Intensive Care, “F. Tappeiner” Hospital, 39012 Merano, Italy)

  • Giacomo Strapazzon

    (Institute of Mountain Emergency Medicine, Eurac Research, 39100 Bolzano, Italy
    Department of Anaesthesia and Intensive Care, Medical University Innsbruck, 6020 Innsbruck, Austria)

  • Marika Falla

    (Institute of Mountain Emergency Medicine, Eurac Research, 39100 Bolzano, Italy
    Center for Mind/Brain Sciences, University of Trento, 38123 Rovereto, 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
    Department of Anaesthesia and Intensive Care, Medical University Innsbruck, 6020 Innsbruck, Austria)

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.

Suggested Citation

  • Ivo B. Regli & Giacomo Strapazzon & Marika Falla & Rosmarie Oberhammer & Hermann Brugger, 2021. "Long-Term Sequelae of Frostbite—A Scoping Review," IJERPH, MDPI, vol. 18(18), pages 1-16, September.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:18:p:9655-:d:634820
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    References listed on IDEAS

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    1. Diana M. Bautista & Jan Siemens & Joshua M. Glazer & Pamela R. Tsuruda & Allan I. Basbaum & Cheryl L. Stucky & Sven-Eric Jordt & David Julius, 2007. "The menthol receptor TRPM8 is the principal detector of environmental cold," Nature, Nature, vol. 448(7150), pages 204-208, July.
    2. David D. McKemy & Werner M. Neuhausser & David Julius, 2002. "Identification of a cold receptor reveals a general role for TRP channels in thermosensation," Nature, Nature, vol. 416(6876), pages 52-58, March.
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    1. Peter Paal & Mathieu Pasquier & Tomasz Darocha & Raimund Lechner & Sylweriusz Kosinski & Bernd Wallner & Ken Zafren & Hermann Brugger, 2022. "Accidental Hypothermia: 2021 Update," IJERPH, MDPI, vol. 19(1), pages 1-25, January.

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