Long-Term Sequelae of Frostbite—A Scoping Review
Abstract
:1. Background
1.1. Epidemiology
1.2. Pathophysiology
1.3. Classification
1.4. Management
2. Methods
3. Results
4. Discussion
5. Limitations
6. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Acknowledgments
Conflicts of Interest
References
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Classification Proposed by Cauchy et al. | Classification Analogous to Burn Injury | |||
---|---|---|---|---|
Extent of Initial Lesion Immediately after Rewarming | Lesion Characteristics * | Time to Onset After Rewarming | ||
first Grade | Absence of initial lesion | first Degree | Partial skin freezing with: Erythema, oedema Skin desquamation | 2–3 h 5–10 days |
second Grade | Initial lesion on distal phalanx | second Degree | Full thickness skin freezing with: Clear blister formation Intensive pain | 12–24 h 3–10 days |
third Grade | Initial lesion on intermediate or proximal phalanx | third Degree | Subcutaneous freezing with: Haemorrhagic blister formation Skin necrosis | 12–24 h 5 days–5 weeks |
fourth Grade | Initial carpal/tarsal lesion | fourth Degree | Freezing deeper than the subcutis with: Cyanotic and insensitive tissue Tissue mummification | Immediately up to 3 months |
Article | Population and Follow Up Timing | Frostbite Grade/Degree | Long-Term Sequelae |
---|---|---|---|
Norheim et al., 2018 [15] | Self-reported data of 397 Norwegian soldiers in 2017 having suffered frostbite from 2010–2014 | 1–2 | 70 % with long-term sequelae 21% unable to work and undertake usual leisure activities |
Carlsson et al., 2014 [16] | Self-reported data of 12 patients; 4 patients with hand frostbite, 6 patients with feet frostbite, and 2 patients with hand and feet frostbite; hand frostbite was followed-up after 4 month and 4 years, foot frostbite only after 4 years | 1–2 | 4 months after frostbite of the hands (n = 6): 100% with discomfort when exposed to cold 67% with cold sensation 67% with white fingers/toes 4 years after frostbite of the hands (n = 6): 100% with discomfort when exposed to cold 83% with cold sensation 17% with white fingers/toes 4 years after frostbite of the feet (n = 8): 89% with discomfort when exposed to cold 100% with cold sensation 100% with white fingers/toes |
Koljonen et al., 2004 [17] | Self-reported data form 14 patients with frostbite during the previous 7 years | Not specified | 15% with daily, intolerable pain 50% chronic pain 50% with limitations in their social life 36% with poor emotional well being |
Ervasti et al., 2000 [18] | Clinical examination of 30 patients with frostbite 4–11 years earlier | 2 | 63% with sequelae of any kind 66% with increased tendency for vasospasm 53% with hypersensitivity to cold 40% with numbness of fingers 33% with declined sensitivity to touch 13% with lowered working ability |
Arvesen et al., 1996 * [19] | Clinical examination of 40 Norwegian soldiers with frostbite in the previous 21–78 months; 16 with involvement of the hands and 24 with involvement of the feet | 1–3 | 38% with disturbed sense of cold 38% with disturbed sense of heat 33% skin and nail dystrophia 20% with hyperhidrosis 18% with reduced light-touch perception 18% with reduced pain perceptions 10% with reduced blunt-touch perception 8% with pain on deep pressure5% with paraesthesia 3% with reduced muscle power |
Rosen et al., 1991 * [20] | Self-reported data of 40 Norwegian soldiers with frostbite at least 2 years prior; 18 with involvement of the hands and 28 with involvement of the feet | 1–3 | Hands: 100% with cold hypersensitivity 50% with paraesthesia 61% with hypaesthesia 56% skin and nail dystrophia 44% with pain 6% with hyperaesthesia 6% with hyperhidrosis 6% with arthralgia Feet: 93% with cold hypersensitivity 64% skin and nail dystrophia 54% with pain 46% with paraesthesia 54% with hypaesthesia 14% with hyperhidrosis 11% with hyperaesthesia 7% pain when walking 4% with arthralgia |
Taylor et al., 1989 [21] | 40 US soldiers examined 6 months after frostbite | 1–4 | 65% with neurovascular sequelae (cold sensitivity, paraesthesia, pain, and hyperaesthesia) 8% had to be reassigned to new functions due to symptom severity |
Blair et al., 1957 [22] | Self-reported data of 97 US soldiers with frostbite in previous 4 years; 50 were examined clinically | 2–4 | Self-reported sequelae in winter 71% with numbness 70% with pain 69% with cold feet 58% with abnormal colour 53% with hyperhidrosis 40% with pathology in joints Self-reported sequelae in summer 31% with numbness 45% with pain 24% with cold feet 31% with abnormal colour 78% with hyperhidrosis 25% with pathology in joints Sequelae detected on physical examination 58% with abnormal nails 48% with abnormal colour 42% with hyperhidrosis 28% with joint stiffness |
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Regli, I.B.; Strapazzon, G.; Falla, M.; Oberhammer, R.; Brugger, H. Long-Term Sequelae of Frostbite—A Scoping Review. Int. J. Environ. Res. Public Health 2021, 18, 9655. https://doi.org/10.3390/ijerph18189655
Regli IB, Strapazzon G, Falla M, Oberhammer R, Brugger H. Long-Term Sequelae of Frostbite—A Scoping Review. International Journal of Environmental Research and Public Health. 2021; 18(18):9655. https://doi.org/10.3390/ijerph18189655
Chicago/Turabian StyleRegli, Ivo B., Giacomo Strapazzon, Marika Falla, Rosmarie Oberhammer, and Hermann Brugger. 2021. "Long-Term Sequelae of Frostbite—A Scoping Review" International Journal of Environmental Research and Public Health 18, no. 18: 9655. https://doi.org/10.3390/ijerph18189655