The classification of freezing cold injuries - a NATO research task group position paper
Permanent link
https://hdl.handle.net/10037/30071Date
2023-04-21Type
Journal articleTidsskriftartikkel
Peer reviewed
Author
Norheim, Arne Johan; Sullivan-Kwantes, Wendy; Steinberg, Tuva; Castellani, John; Friedl, Karl E.Abstract
Methodology: A scoping review of the literature using PubMed and cross-checked with Google Scholar, using search terms related to freezing cold injury and frostbite, highlighted a paucity of published clinical papers and little agreement on classification schemes.
Results: A total of 74 papers were identified, and 28 were included in the review. Published reports and studies can be generally grouped into four different classification schemes that are based on (1) injury morphology; (2) signs and symptoms; (3) pathophysiology; and (4) clinical outcome. The nomenclature in the different classification systems is not coherent and the discrete classification limits are not evidence based.
Conclusions: All the classification systems are necessary and relevant to FCI medical management for sustainment of soldier health and performance in cold weather operations and winter warfare. Future FCI reports should clearly characterise the nature of the FCI into existing classification schemes for surveillance (morphology, symptoms, and appearance), identifying risk-factors, clinical guidelines, and agreed inclusion/exclusion criteria for a future treatment trial.