Freezing and non-freezing cold weather injuries: a systematic review

Introduction: The debilitating impact of cold weather on the human body is one of the world's oldest recorded injuries. The severe and life-changing damage which can be caused is now more commonly seen recreationally in extreme outdoor sports rather than in occupational settings such as the military. The diagnosis and treatment of these injuries need to be completed carefully but quickly to reduce the risk of loss of limb and possibly life. Therefore, we have conducted a systematic review of the literature surrounding cold weather injuries (CWIs) to ascertain the epidemiology and current management strategies. Sources of data: Medline (PubMED), EMBASE, CINHAL, Cochrane Collaboration Database, Web of Science, Scopus and Google Scholar. Areas of agreement immediate field treatment: The risk of freeze thaw freeze injuries. Delayed surgical intervention when possible. Different epidemiology of freezing and non-freezing injuries. Areas of controversy: Prophylatic use of antibiotics; the use of vasodilators surgical and medical. Growing points: The use of ilioprost and PFG2a for the treatment of deep frostbite. Areas timely for developing research: The treatment of non-freezing CWIs with their long-term follow-up.