학술논문
The classification of freezing cold injuries - a NATO research task group position paper.
Document Type
Academic Journal
Author
Norheim AJ; National Research Center in Complementary and Alternative Medicine (NAFKAM), Institute of Community Medicine, UiT- The Arctic University of Norway, Tromsø, Norway.; Sullivan-Kwantes W; Joint medical services, Defence Research and Development Canada-Toronto Research Center, Sessvollmoen.; Steinberg T; National Research Center in Complementary and Alternative Medicine (NAFKAM), Institute of Community Medicine, UiT- The Arctic University of Norway, Tromsø, Norway.; Norwegian Armed Forces - Joint Medical Service, Norway.; Castellani J; U.S. Army Research Institute of Environmental Medicine, Natick MA USA.; Friedl KE; U.S. Army Research Institute of Environmental Medicine, Natick MA USA.
Source
Publisher: Taylor & Francis Country of Publication: United States NLM ID: 9713056 Publication Model: Print Cited Medium: Internet ISSN: 2242-3982 (Electronic) Linking ISSN: 12399736 NLM ISO Abbreviation: Int J Circumpolar Health Subsets: MEDLINE
Subject
Language
English
Abstract
Introduction: Freezing cold injuries (FCI) are a common risk in extreme cold weather operations. Although the risks have long been recognised, injury occurrences tend to be sparse and geographically distributed, with relatively few cases to study in a systematic way. The first challenge to improve FCI medical management is to develop a common nomenclature for FCI classification. This is critical for the development of meaningful epidemiological reports on the magnitude and severity of FCI, for the standardisation of patient inclusion criteria for treatment studies, and for the development of clinical diagnosis and treatment algorithms.
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.
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.