Zaramo TZ, Green JK, Janis JE, et al.
Plastic and reconstructive surgery. Global open. Date of publication 2022 Oct 24;volume 10(10):e4618.
1. Plast Reconstr Surg Glob Open. 2022 Oct 24;10(10):e4618. doi:
10.1097/GOX.0000000000004618. eCollection 2022 Oct.
Practical Review of the Current Management of Frostbite Injuries.
Zaramo TZ(1), Green JK(1), Janis JE(1).
Author information:
(1)Department of Plastic and Reconstructive Surgery, The Ohio State University
Wexner Medical Center, Columbus, Ohio.
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.
Copyright © 2022 The Authors. Published by Wolters Kluwer Health, Inc. on behalf
of The American Society of Plastic Surgeons.
DOI: 10.1097/GOX.0000000000004618
PMCID: PMC9592504
PMID: 36299821
