Whitehorse General Hospital, Yukon Hospital Corporation, Whitehorse, Yukon, Canada.
Northern Medical Program, University of British Columbia, Prince George, British Columbia, Canada.
Int J Circumpolar Health. 2023 Dec;82(1):2189552. doi: 10.1080/22423982.2023.2189552.
We performed a scoping review to identify the extent of the literature describing the use of iloprost in the treatment of frostbite. Iloprost is a stable synthetic analog of prostaglandin I. As a potent inhibitor of platelet aggregation and vasodilator, it has been used to address the post-rewarming reperfusion injury in frostbite. The search using iloprost and frostbite as key words and MeSH terms yielded 200 articles. We included in our review the literature examining iloprost for the treatment of frostbite in humans in the form of primary research, conference proceedings and abstracts. Twenty studies published from 1994 to 2022 were selected for analysis. The majority were retrospective case series consisting of a homogeneous population of mountain sport enthusiasts. A total of 254 patients and over 1000 frostbitten digits were included among the 20 studies. The larger case series demonstrated a decrease in amputation rates relative to untreated patients. Primary gaps in the literature include a paucity of randomised trials and relatively limited study populations to date. While the case evidence is promising, a multi-centre collaboration would be crucial to adequately power prospective randomised studies to definitively determine if iloprost has a role in the treatment of frostbite.
我们进行了范围综述，以确定描述使用前列环素治疗冻伤的文献的范围。前列环素是前列腺素 I 的稳定合成类似物。作为血小板聚集抑制剂和血管扩张剂，它已被用于解决冻伤后的再灌注损伤。使用前列环素和冻伤作为关键词和 MeSH 术语进行搜索，得到了 200 篇文章。我们将研究前列环素治疗人类冻伤的文献纳入综述，包括原始研究、会议记录和摘要。从 1994 年到 2022 年，共选择了 20 项研究进行分析。这些研究大多数是回顾性病例系列研究，研究对象是同质的山地运动爱好者群体。在这 20 项研究中，共有 254 名患者和超过 1000 个冻伤的手指被纳入。较大的病例系列研究表明，与未治疗的患者相比，截肢率有所下降。文献中的主要空白包括缺乏随机试验和迄今为止相对有限的研究人群。虽然病例证据很有希望，但多中心合作对于进行充分的前瞻性随机研究至关重要，以确定前列环素是否在治疗冻伤方面发挥作用。
