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.
>> Vollständiger Beitrag "Long-Term Sequelae of Frostbite—A Scoping Review" auf MDPI.COM
Zweiter Beitrag zur lokalen Erfrierungsschäden
Alle Beiträge zum Thema Hypothermie
Autor(en): Prim. PD Dr. med. Peter Paal MBA EDAIC EDIC
Kategorie: Blog, Alpine Notfallmedizin, Hypothermie
Datum: 24. Mär 2022
Zwei Artikel beschäftigten sich mit lokalen Kälteschäden, der erste mit nicht lokalen Nicht-Erfrierungsschäden. Im zweiten Artikel berichten Regli I et al. von Langzeitschäden nach Erfrierungsschäden.
21. Mär 2022
Blog
Alpine Notfallmedizin
Hypothermie
Dieser spannende Artikel von Brodmann M et al. diskutiert die gefährliche Wechselwirkung von Trauma und akzidenteller Hypothermie.
13. Mär 2022
Blog
Alpine Notfallmedizin
Hypothermie
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