Table 2.
Included Study | Rewarming method | Time from injury or rewarming to iloprost | Iloprost dose | Iloprost duration | Other medications used | Wound care | HBOT |
---|---|---|---|---|---|---|---|
Groechenig 1994 [21] | - | - | 0.5 to 2 ng/kg/min continuous IV | 14–42 days | Cortisone LMWH |
- | No |
Hödl 2005 [38] | - | 1 to 9 days from injury | 10 to 25 mcg IV daily | 3 to 8 weeks | ASA Analgesic Clindamycin Dextran Enoxaparin Flucloxacillin Neuroleptic |
Octenisept solution Aspiration of blisters Bacitracin/neomycin powder Strips between digits Cotton bandage Aquacel dressing |
No |
Roche-Nagle et al. 2008 [39] | - | - | - | - | ASA Antibiotics Heparin NSAIDs |
- | No |
Imray et al. 2009 [40] | - | 5 days from rewarming | - | 5 days | - | - | No |
Cauchy et al. 2011 [41] | Rapid | < or >12 hours | 0.5 to 2 ng/kg/min for 6 hours IV daily | 8 days | ASA Alteplase |
- | No |
Gorjanc et al. 2012 [42] | Rapid | <3 days from injury in majority | 1 to 2 ng/kg/min for 6 hours IV daily | 5 to 10 days | ASA Amox/clav Dalteparin/enoxaparin Pentoxifylline |
- | 10 to 30 days |
Haik J et al. 2016 [43] | - | 1 day from rewarming | 2 ng/kg/min for 6 hours IV daily | 6 days | ASA Cephalexin Enoxaparin Ibuprofen |
Debridement Vaseline gauze Gauze soaked in mafenid acetate |
30 sessions |
Cauchy et al. 2016 [44] | Rapid | - | - | - | ASA Alteplase (“tPA”; IV) |
- | No |
Poole & Gauthier 2016 [45] | Passive and rapid | <24 to 48 hours from rewarming | 0.5 to 2 ng/kg/min for 6 hours IV daily | 5 days | Fentanyl Ibuprofen Morphine |
Hydrotherapy whirlpool daily Aspiration of clear blister Low-adherent dressings Topical Aloe vera |
No |
Lindford et al. 2017 [46] | Rapid | 28 hours from injury in 1 case | 0.5 to 2 ng/kg/min for 6 hours IV daily | 2 to 3 days | ASA Alteplase (IA) Cephalosporin Enoxaparin Opioid analgesia Pantoprazole Papaverine Paracetamol Regional nerve block Simvastatin UFH |
Debridement of blisters Polyurethane finger or Silver-based foam dressings |
No |
Pandey et al. 2018 [47] | Passive | 32 to 72 hours from injury | 2 to 10 mcg/hour for 6 hours IV daily (per patient weight; titrated up to 2 ng/kg/min) | 5 days | ASA Ceftriaxone Cephalexin |
Draining of large blisters Non adherent dressing |
No |
Gorjanc et al. 2018 [48] | - | - | - | - | Amox/clav Enoxaparin Ibuprofen Pantoprazole Pentoxifylline |
- | Yes |
Irarrazaval et al. 2018 [49] | Rapid | 75 hours from injury | 2 ng/kg/min for 6 hours IV daily | 4 days | ASA Cephalexin Ibuprofen Sildenafil |
Daily dressing change | 5 days |
Jud et al. 2019 [50] | - | - | 20 mcg IV daily | 10 days | ASA Enoxaparin |
Draining of lesions Topical betamethasone |
No |
Lorenzo-Villalba et al. 2021 [51] | Passive | 8 days from injury | n/a | 5 days | ASA Bendamustine and rituximab (for Cold Agglutinin Disease) |
Evacuation of hematomas | No |
Poole et al. 2021 [52] | Passive and rapid | <1 to 55 hours from presentation | 2 to 10 mcg/hour for 6 hours IV daily (per patient weight; titrated up to 2 ng/kg/min) | 1 to 5 days | Alteplase (IV) Ibuprofen UFH |
Daily hydrotherapy Debridement and aspiration of clear blisters Topical aloe vera |
No |
MacLennan et al. 2021 [53] | - | - | 2 to 10 mcg/hour for 6 hours IV daily | 5 days | - | - | No |
Magnan et al. 2021 [54] | Rapid | <6 to 72 hours (majority 12 to 48 hours) from injury | 8 to 10 mcg/hour for 6 hours IV daily | 7 days | ASA Amox/clav |
Topical hyaluronic acid daily | 14 sessions |
Magnan et al. 2022 [55] | Passive | 70 hours from injury | 10 mcg/hour for 6 hours IV daily | 7 days | ASA Amox/clav Heparin |
Daily warm bath/betadine Bandage with hyaluronic acid Early physiotherapy |
30 sessions |
Crooks et al. 2022 [56] | - | <12 to >72 hours (majority<12 hours) from injury to presentation | 2 to 10 mcg/hour for 6 hours IV daily (maximum 50 mcg/day) | 5 days | ASA Alteplase IV/IA (Grade 4) Antibiotics Ibuprofen Nitroglycerin UFH (Grade 4) |
- | No |
“HBOT” = Hyperbaric Oxygen Therapy, “-” = information not available, “IV” = intravenous, “IA” = intra-arterial, “ASA” = Acetylsalicylic acid.
“Amox/clav” = Amoxicillin/clavulanic acid, “LMWH” = Low Molecular Weight Heparin”, “UFH” = Unfractionated heparin.