Frostbite treatment: a systematic review with meta-analyses
Abstract Introduction Our objective was to perform a systematic review of the outcomes of various frostbite treatments to determine which treatments are effective. We also planned to perform meta-analyses of the outcomes of individual treatments for which suitable data were available. Main Body We p...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-12-01
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| Series: | Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13049-023-01160-3 |
| _version_ | 1797388104731983872 |
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| author | Ivo B. Regli Rosmarie Oberhammer Ken Zafren Hermann Brugger Giacomo Strapazzon |
| author_facet | Ivo B. Regli Rosmarie Oberhammer Ken Zafren Hermann Brugger Giacomo Strapazzon |
| author_sort | Ivo B. Regli |
| collection | DOAJ |
| description | Abstract Introduction Our objective was to perform a systematic review of the outcomes of various frostbite treatments to determine which treatments are effective. We also planned to perform meta-analyses of the outcomes of individual treatments for which suitable data were available. Main Body We performed a systematic review and meta-analyses in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. We searched PubMed, Cochrane Trials, and EMBase to identify primary references from January 1, 1900, to June 18, 2022. After eliminating duplicates, we screened abstracts to identify eligible studies containing information on treatment and outcomes of Grade 2 to 4 frostbite. We performed meta-analyses of groups of articles that provided sufficient data. We registered our review in the prospective registry of systematic reviews PROSPERO (Nr. 293,693). We identified 4,835 potentially relevant studies. We excluded 4,610 studies after abstract screening. We evaluated the full text of the remaining 225 studies, excluding 154. Ultimately, we included 71 articles with 978 cases of frostbite originating from 1 randomized controlled trial, 20 cohort studies and 51 case reports. We found wide variations in classifications of treatments and outcomes. The two meta-analyses we performed both found that patients treated with thrombolytics within 24 h had better outcomes than patients treated with other modalities. The one randomized controlled trial found that the prostacyclin analog iloprost was beneficial in severe frostbite if administered within 48 h. Conclusions Iloprost and thrombolysis may be beneficial for treating frostbite. The effectiveness of other commonly used treatments has not been validated. More prospective data from clinical trials or an international registry may help to inform optimal treatment. |
| first_indexed | 2024-03-08T22:34:57Z |
| format | Article |
| id | doaj.art-062a99aa9786429e8a42ec6c1e47aaa7 |
| institution | Directory Open Access Journal |
| issn | 1757-7241 |
| language | English |
| last_indexed | 2024-03-08T22:34:57Z |
| publishDate | 2023-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine |
| spelling | doaj.art-062a99aa9786429e8a42ec6c1e47aaa72023-12-17T12:28:29ZengBMCScandinavian Journal of Trauma, Resuscitation and Emergency Medicine1757-72412023-12-0131111110.1186/s13049-023-01160-3Frostbite treatment: a systematic review with meta-analysesIvo B. Regli0Rosmarie Oberhammer1Ken Zafren2Hermann Brugger3Giacomo Strapazzon4Institute of Mountain Emergency Medicine, EURAC ResearchDepartment of Anesthesia and Intensive Care, Hospital of BrunicoDepartment of Emergency Medicine, Alaska Native Medical CenterInstitute of Mountain Emergency Medicine, EURAC ResearchInstitute of Mountain Emergency Medicine, EURAC ResearchAbstract Introduction Our objective was to perform a systematic review of the outcomes of various frostbite treatments to determine which treatments are effective. We also planned to perform meta-analyses of the outcomes of individual treatments for which suitable data were available. Main Body We performed a systematic review and meta-analyses in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. We searched PubMed, Cochrane Trials, and EMBase to identify primary references from January 1, 1900, to June 18, 2022. After eliminating duplicates, we screened abstracts to identify eligible studies containing information on treatment and outcomes of Grade 2 to 4 frostbite. We performed meta-analyses of groups of articles that provided sufficient data. We registered our review in the prospective registry of systematic reviews PROSPERO (Nr. 293,693). We identified 4,835 potentially relevant studies. We excluded 4,610 studies after abstract screening. We evaluated the full text of the remaining 225 studies, excluding 154. Ultimately, we included 71 articles with 978 cases of frostbite originating from 1 randomized controlled trial, 20 cohort studies and 51 case reports. We found wide variations in classifications of treatments and outcomes. The two meta-analyses we performed both found that patients treated with thrombolytics within 24 h had better outcomes than patients treated with other modalities. The one randomized controlled trial found that the prostacyclin analog iloprost was beneficial in severe frostbite if administered within 48 h. Conclusions Iloprost and thrombolysis may be beneficial for treating frostbite. The effectiveness of other commonly used treatments has not been validated. More prospective data from clinical trials or an international registry may help to inform optimal treatment.https://doi.org/10.1186/s13049-023-01160-3FrostbiteCold injuryCold exposure systematic reviewMeta-analysisThrombolysisIloprost |
| spellingShingle | Ivo B. Regli Rosmarie Oberhammer Ken Zafren Hermann Brugger Giacomo Strapazzon Frostbite treatment: a systematic review with meta-analyses Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine Frostbite Cold injury Cold exposure systematic review Meta-analysis Thrombolysis Iloprost |
| title | Frostbite treatment: a systematic review with meta-analyses |
| title_full | Frostbite treatment: a systematic review with meta-analyses |
| title_fullStr | Frostbite treatment: a systematic review with meta-analyses |
| title_full_unstemmed | Frostbite treatment: a systematic review with meta-analyses |
| title_short | Frostbite treatment: a systematic review with meta-analyses |
| title_sort | frostbite treatment a systematic review with meta analyses |
| topic | Frostbite Cold injury Cold exposure systematic review Meta-analysis Thrombolysis Iloprost |
| url | https://doi.org/10.1186/s13049-023-01160-3 |
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