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The Canadian Frostbite Care Network does not provide formal medical consultations or specific medical advice. Frostbite assessment and care is variable between centres and physicians, as currently there is no clearly defined standard of care in the medical literature.
Patients are encouraged to connect with their local care teams through the Emergency Department and/or Primary Care provider, who are best positioned to facilitate consultation and/or transfer of care to appropriate local specialists or centres.
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Commissioner O of the. FDA. FDA; 2024 [cited 2024 Jun 27]. FDA Approves First Medication to Treat Severe Frostbite. Available from: https://www.fda.gov/news-events/press-announcements/fda-approves-first-medication-treat-severe-frostbite.
Lorentzen AK, Penninga L. Frostbite-A Case Series From Arctic Greenland. Wilderness Environ Med. 2018 Sep;29(3):392–400.
Commissioner O of the. FDA. FDA; 2024 [cited 2024 Jun 27]. FDA Approves First Medication to Treat Severe Frostbite. Available from: https://www.fda.gov/news-events/press-announcements/fda-approves-first-medication-treat-severe-frostbite.
Lorentzen AK, Penninga L. Frostbite-A Case Series From Arctic Greenland. Wilderness Environ Med. 2018 Sep;29(3):392–400.
Zhang Y, Song J, Huang G. Comprehensive Treatment of Single Finger Frostbite: A Case Study. J Burn Care Res Off Publ Am Burn Assoc. 2021 May 7;42(3):555–9.
McIntosh SE, Freer L, Grissom CK, Auerbach PS, Rodway GW, Cochran A, et al. Wilderness Medical Society Clinical Practice Guidelines for the Prevention and Treatment of Frostbite: 2019 Update. Wilderness Environ Med. 2019 Dec 1;30(4):S19–32.
Lorentzen AK, Penninga L. Frostbite-A Case Series From Arctic Greenland. Wilderness Environ Med. 2018 Sep;29(3):392–400.
Zhang Y, Song J, Huang G. Comprehensive Treatment of Single Finger Frostbite: A Case Study. J Burn Care Res Off Publ Am Burn Assoc. 2021 May 7;42(3):555–9.
McIntosh SE, Freer L, Grissom CK, Auerbach PS, Rodway GW, Cochran A, et al. Wilderness Medical Society Clinical Practice Guidelines for the Prevention and Treatment of Frostbite: 2019 Update. Wilderness Environ Med. 2019 Dec 1;30(4):S19–32.
Regli IB, Strapazzon G, Falla M, Oberhammer R, Brugger H. Long-Term Sequelae of Frostbite-A Scoping Review. Int J Environ Res Public Health. 2021 Sep 14;18(18):9655.
Higdon B, Youngman L, Regehr M, Chiou A. Deep Frostbite Treated With Hyperbaric Oxygen and Thrombolytic Therapies. Wounds Compend Clin Res Pract. 2015 Aug;27(8):215–23.
Davis A, Sinopoli B, Mann N, Stenbit AE. A Photographic Case of Frostbite Treated with Delayed Hyperbaric Oxygen Therapy. High Alt Med Biol. 2022 Jun;23(2):194–7.
Coward A, Endorf FW, Nygaard RM. Revision Surgery Following Severe Frostbite Injury Compared to Similar Hand and Foot Burns. J Burn Care Res Off Publ Am Burn Assoc. 2022 Sep 1;43(5):1015–8.
Endorf FW, Nygaard RM. Social Determinants of Poor Outcomes Following Frostbite Injury: A Study of the National Inpatient Sample. J Burn Care Res Off Publ Am Burn Assoc. 2021 Nov 24;42(6):1261–5.
Rossis CG, Yiacoumettis AM, Elemenoglou J. Squamous cell carcinoma of the heel developing at site of previous frostbite. J R Soc Med. 1982 Sep;75(9):715–8.
Mohr WJ, Jenabzadeh K, Ahrenholz DH. Cold injury. Hand Clin. 2009 Nov;25(4):481–96.
Weatherley-White RCA, Sjostrom B, Paton BC. Experimental studies in cold injury: II. The pathogenesis of frostbite. J Surg Res. 1964 Jan 1;4(1):17–22.
Quintanilla R, Krusen FH, Essex HE. Studies on frost-bite with special reference to treatment and the effect on minute blood vessels. Am J Physiol. 1947 Apr;149(1):149–61.
Manson PN, Jesudass R, Marzella L, Bulkley GB, Im MJ, Narayan KK. Evidence for an early free radical-mediated reperfusion injury in frostbite. Free Radic Biol Med. 1991;10(1):7–11.
Robson MC, Heggers JP. Evaluation of hand frostbite blister fluid as a clue to pathogenesis. J Hand Surg. 1981 Jan;6(1):43–7.
McIntosh SE, Freer L, Grissom CK, Rodway GW, Giesbrecht GG, McDevitt M, et al. Wilderness Medical Society Clinical Practice Guidelines for the Prevention and Treatment of Frostbite: 2024 Update. Wilderness Environ Med. 2024 Jun;35(2):183–97.
Wibbenmeyer L, Lacey AM, Endorf FW, Logsetty S, Wagner ALL, Gibson ALF, et al. American Burn Association Clinical Practice Guidelines on the Treatment of Severe Frostbite. J Burn Care Res Off Publ Am Burn Assoc. 2023 Apr 13;irad022.
Higdon B, Youngman L, Regehr M, Chiou A. Deep Frostbite Treated With Hyperbaric Oxygen and Thrombolytic Therapies. Wounds Compend Clin Res Pract. 2015 Aug;27(8):215–23.
Davis A, Sinopoli B, Mann N, Stenbit AE. A Photographic Case of Frostbite Treated with Delayed Hyperbaric Oxygen Therapy. High Alt Med Biol. 2022 Jun;23(2):194–7.
Coward A, Endorf FW, Nygaard RM. Revision Surgery Following Severe Frostbite Injury Compared to Similar Hand and Foot Burns. J Burn Care Res Off Publ Am Burn Assoc. 2022 Sep 1;43(5):1015–8.
Endorf FW, Nygaard RM. Social Determinants of Poor Outcomes Following Frostbite Injury: A Study of the National Inpatient Sample. J Burn Care Res Off Publ Am Burn Assoc. 2021 Nov 24;42(6):1261–5.
Rossis CG, Yiacoumettis AM, Elemenoglou J. Squamous cell carcinoma of the heel developing at site of previous frostbite. J R Soc Med. 1982 Sep;75(9):715–8.
Mohr WJ, Jenabzadeh K, Ahrenholz DH. Cold injury. Hand Clin. 2009 Nov;25(4):481–96.
Weatherley-White RCA, Sjostrom B, Paton BC. Experimental studies in cold injury: II. The pathogenesis of frostbite. J Surg Res. 1964 Jan 1;4(1):17–22.
Quintanilla R, Krusen FH, Essex HE. Studies on frost-bite with special reference to treatment and the effect on minute blood vessels. Am J Physiol. 1947 Apr;149(1):149–61.
Zhang Y, Song J, Huang G. Comprehensive Treatment of Single Finger Frostbite: A Case Study. J Burn Care Res Off Publ Am Burn Assoc. 2021 May 7;42(3):555–9.
Quintanilla R, Krusen FH, Essex HE. Studies on frost-bite with special reference to treatment and the effect on minute blood vessels. Am J Physiol. 1947 Apr;149(1):149–61.
Gauthier J, Morris-Janzen D, Poole A. Iloprost for the treatment of frostbite: a scoping review. Int J Circumpolar Health. 2023 Dec;82(1):2189552.
Quintanilla R, Krusen FH, Essex HE. Studies on frost-bite with special reference to treatment and the effect on minute blood vessels. Am J Physiol. 1947 Apr;149(1):149–61.
McCauley RL, Heggers JP, Robson MC. Frostbite. Methods to minimize tissue loss. Postgrad Med. 1990 Dec;88(8):67–8, 73–7.
McCauley RL, Hing DN, Robson MC, Heggers JP. Frostbite injuries: a rational approach based on the pathophysiology. J Trauma. 1983 Feb;23(2):143–7.
Heggers JP, Robson MC, Manavalen K, Weingarten MD, Carethers JM, Boertman JA, et al. Experimental and clinical observations on frostbite. Ann Emerg Med. 1987 Sep;16(9):1056–62.
McIntosh SE, Freer L, Grissom CK, Rodway GW, Giesbrecht GG, McDevitt M, et al. Wilderness Medical Society Clinical Practice Guidelines for the Prevention and Treatment of Frostbite: 2024 Update. Wilderness Environ Med. 2024 Jun;35(2):183–97.
Heggers JP, Robson MC, Manavalen K, Weingarten MD, Carethers JM, Boertman JA, et al. Experimental and clinical observations on frostbite. Ann Emerg Med. 1987 Sep;16(9):1056–62.
Manson PN, Jesudass R, Marzella L, Bulkley GB, Im MJ, Narayan KK. Evidence for an early free radical-mediated reperfusion injury in frostbite. Free Radic Biol Med. 1991;10(1):7–11.
McCauley RL, Heggers JP, Robson MC. Frostbite. Methods to minimize tissue loss. Postgrad Med. 1990 Dec;88(8):67–8, 73–7.
McCauley RL, Hing DN, Robson MC, Heggers JP. Frostbite injuries: a rational approach based on the pathophysiology. J Trauma. 1983 Feb;23(2):143–7.
Heggers JP, Robson MC, Manavalen K, Weingarten MD, Carethers JM, Boertman JA, et al. Experimental and clinical observations on frostbite. Ann Emerg Med. 1987 Sep;16(9):1056–62.
McCauley RL, Hing DN, Robson MC, Heggers JP. Frostbite injuries: a rational approach based on the pathophysiology. J Trauma. 1983 Feb;23(2):143–7.
Heggers JP, Robson MC, Manavalen K, Weingarten MD, Carethers JM, Boertman JA, et al. Experimental and clinical observations on frostbite. Ann Emerg Med. 1987 Sep;16(9):1056–62.
Kahle AC, Cooper JS. Hyperbaric Physiological And Pharmacological Effects of Gases. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 [cited 2023 Dec 29]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK470481/
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Ghumman A, St Denis-Katz H, Ashton R, Wherrett C, Malic C. Treatment of Frostbite With Hyperbaric Oxygen Therapy: A Single Center’s Experience of 22 Cases. Wounds Compend Clin Res Pract. 2019 Dec;31(12):322–5.
Magnan MA, Gayet-Ageron A, Louge P, Champly F, Joffre T, Lovis C, et al. Hyperbaric Oxygen Therapy with Iloprost Improves Digit Salvage in Severe Frostbite Compared to Iloprost Alone. Med Kaunas Lith. 2021 Nov 22;57(11):1284.
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Bruen KJ, Ballard JR, Morris SE, Cochran A, Edelman LS, Saffle JR. Reduction of the incidence of amputation in frostbite injury with thrombolytic therapy. Arch Surg Chic Ill 1960. 2007 Jun;142(6):546–51; discussion 551-553.
Ibrahim AE, Goverman J, Sarhane KA, Donofrio J, Walker TG, Fagan SP. The emerging role of tissue plasminogen activator in the management of severe frostbite. J Burn Care Res Off Publ Am Burn Assoc. 2015;36(2):e62-66.
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Santapau A, Razola P, Tardin L, Andrés A, Prats E, Banzo J. The role of bone scanning in severe frostbite of the feet in a mountaineer. Rev Espanola Med Nucl E Imagen Mol. 2013 Mar;32(2):113–4.
Cauchy E, Chetaille E, Lefevre M, Kerelou E, Marsigny B. The role of bone scanning in severe frostbite of the extremities: a retrospective study of 88 cases. Eur J Nucl Med. 2000 May;27(5):497–502.
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Lacey AM, Fey RM, Gayken JR, Endorf FW, Schmitz KR, Punjabi GV, et al. Microangiography: An Alternative Tool for Assessing Severe Frostbite Injury. J Burn Care Res Off Publ Am Burn Assoc. 2019 Aug 14;40(5):566–9.
Raleigh SM, Samson M, Nygaard R, Endorf F, Walter J, Masters T. Bedside Fluorescence Microangiography for Frostbite Diagnosis in the Emergency Department. West J Emerg Med. 2022 Oct 23;23(6):872–7.
Poole A, Gauthier J, MacLennan M. Management of severe frostbite with iloprost, alteplase and heparin: a Yukon case series. CMAJ Open. 2021 Jun;9(2):E585–91.
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Cauchy E, Chetaille E, Lefevre M, Kerelou E, Marsigny B. The role of bone scanning in severe frostbite of the extremities: a retrospective study of 88 cases. Eur J Nucl Med. 2000 May;27(5):497–502.
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Richard L, Golding H, Saskin R, Jenkinson JIR, Francombe Pridham K, Gogosis E, et al. Cold-related injuries among patients experiencing homelessness in Toronto: a descriptive analysis of emergency department visits. CJEM. 2023 Aug;25(8):695–703.
Endorf FW, Nygaard RM. Social Determinants of Poor Outcomes Following Frostbite Injury: A Study of the National Inpatient Sample. J Burn Care Res Off Publ Am Burn Assoc. 2021 Nov 24;42(6):1261–5.
Endorf FW, Alapati D, Xiong Y, DiGiandomenico C, Rasimas CS, Rasimas JJ, et al. Biopsychosocial factors associated with complications in patients with frostbite. Medicine (Baltimore). 2022 Aug 26;101(34):e30211.
Richard L, Golding H, Saskin R, Jenkinson JIR, Francombe Pridham K, Gogosis E, et al. Cold-related injuries among patients experiencing homelessness in Toronto: a descriptive analysis of emergency department visits. CJEM. 2023 Aug;25(8):695–703.
McIntosh SE, Freer L, Grissom CK, Rodway GW, Giesbrecht GG, McDevitt M, et al. Wilderness Medical Society Clinical Practice Guidelines for the Prevention and Treatment of Frostbite: 2024 Update. Wilderness Environ Med. 2024 Jun;35(2):183–97.
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C R, Am L, Fw E, G P, A W, J G, et al. The Effects of Rapid Rewarming on Tissue Salvage in Severe Frostbite Injury. J Burn Care Res Off Publ Am Burn Assoc [Internet]. 2022 Jul 1 [cited 2024 Oct 8];43(4). Available from: https://pubmed.ncbi.nlm.nih.gov/34791315/
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Drinane J, Kotamarti VS, O’Connor C, Nair L, Divanyan A, Roth MZ, et al. Thrombolytic Salvage of Threatened Frostbitten Extremities and Digits: A Systematic Review. J Burn Care Res Off Publ Am Burn Assoc. 2019 Aug 14;40(5):541–9.
Drinane J, Heiman AJ, Ricci JA, Patel A. Thrombolytic Salvage of the Frostbitten Upper Extremity: A Systematic Review. Hand N Y N. 2022 May;17(3):397–404.
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Hutchison RL, Miller HM, Michalke SK. The Use of tPA in the Treatment of Frostbite: A Systematic Review. Hand N Y N. 2019 Jan;14(1):13–8.
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Heggers JP, Phillips LG, McCauley RL, et al. Frostbite: experimental and clinical evaluations of treatment. J Wilderness Med. 1990:27–32.
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Ilomedin Package Insert. Bayer HealthCare
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Poole A, Gauthier J, MacLennan M. Management of severe frostbite with iloprost, alteplase and heparin: a Yukon case series. CMAJ Open. 2021 Jun;9(2):E585–91.
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Cauchy E, Chetaille E, Pham E, et al. Iloprost With and Without rt-PA: Treatment of 131 Cases of Severe Frostbite. 7th World Congress of Mountain and Wilderness Medicine. Telluride, Colorado. July 30 - August 4, 2016. (Abstract)
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