Key result
Iloprost demonstrated a decrease in amputation rates relative to untreated patients in larger case series of frostbite, though randomized trials are lacking.
Why the study?
Iloprost has been used to address post-rewarming reperfusion injury in frostbite, prompting a review of the literature examining its use for treating frostbite in humans.
Does iloprost reduce amputation rates in patients with frostbite?
Does iloprost reduce amputation rates in patients with frostbite?
Iloprost shows promise in reducing amputation rates in frostbite, though evidence is currently limited to mostly retrospective case series.
May support iloprost consideration in severe frostbite; leaves open efficacy and protocols pending randomized trials.
. 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.
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Gauthier et al. (2023) conducted a review in Frostbite (n=254). Iloprost vs. Untreated patients was evaluated on Amputation rates. Iloprost demonstrated a decrease in amputation rates relative to untreated patients in larger case series of frostbite, though randomized trials are lacking.