Potential new treatment for non-freezing cold injury: is Iloprost the way forward?
BACKGROUND
Non-freezing cold injury (NFCI) remains largely under-reported, and is of particular importance in the armed forces where its prevalence is greatest. Iloprost, a synthetic prostaglandin I2analogue, has previously been used with some success in the treatment of vasospastic and freezing cold injuries, although its role in NFCI remains unclear.


METHODS
An Iloprost infusion was used to treat the long-term sequelae of an ex-soldier suffering with ongoing pedal pain and loss of function 20 years after the initial NFCI insult sustained on military exercise. Following 5 days of iloprost infusion, he reported 4 weeks of markedly reduced pain and increased mobility before symptom relapse. A second infusion was thus given 3 months later, which resulted in increased pain and analgesic requirements.


CONCLUSIONS
The use of iloprost in the treatment of NFCI is discussed and its use in a condition which physicians consistently struggle to treat effectively is considered. Careful counselling is recommended as symptoms may be worsened.
Department of Vascular Surgery, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK.
Anne-Marie
AM
Ionescu
Department of Vascular Surgery, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK.
Sarah
S
Hutchinson
Department of Vascular Surgery, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK.
Mehtab
M
Ahmad
Department of Vascular Surgery, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK.|Warwick Medical School, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK.
Christopher
C
Imray
D000328:Adult; D000067390:Cold Injury / Q000150:complications / Q000503:physiopathology; D018409:Foot Injuries / Q000150:complications / Q000503:physiopathology; D006801:Humans; D016285:Iloprost / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D007262:Infusions, Intravenous; D008297:Male; D008889:Military Personnel; D010146:Pain / Q000188:drug therapy / Q000209:etiology; D006113:United Kingdom; D014665:Vasodilator Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use
D014665:Vasodilator Agents; D016285:Iloprost
cold weather injuries; hypothermia; iloprost; non-freezing cold injury