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Early Use of Iloprost in Nonfreezing Cold Injury
Adam Tam1, Thomas Lyons1, Sarath Vennam1
1Royal Cornwall Hospitals NHS Trust, United Kingdom.
Wilderness & Environmental Medicine
|July 15, 2022
Summary
This case study shows that iloprost, a medication, may safely reduce tissue loss in severe nonfreezing cold injury (NFCI). Early iloprost infusion and delayed surgery are key for preserving function in cold-injured patients.
Area of Science:
- Emergency Medicine
- Vascular Medicine
- Dermatology
Background:
- Nonfreezing cold injury (NFCI) results from prolonged cold, wet exposure, distinct from frostbite.
- Its pathophysiology involves vasoconstriction and microcirculatory issues.
- Iloprost, a prostaglandin analogue, is used for frostbite but its role in NFCI is not well-defined.
Observation:
- A 29-year-old man experienced severe NFCI in both feet after cold seawater immersion.
- Initial treatment included passive rewarming, analgesia, and aspirin.
- Iloprost infusion was administered within 24 hours and was well-tolerated.
Findings:
- Iloprost treatment appeared to reduce tissue loss compared to initial assessments.
- Delayed surgical intervention enabled minor debridement and amputations.
- The patient retained the ability to ambulate.
Implications:
- This case suggests iloprost is safe for acute NFCI management.
- It underscores the importance of delayed surgical intervention for severe NFCI.
- Iloprost may be a valuable adjuvant therapy for nonfreezing cold injuries.
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