{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T23:36:17Z","timestamp":1791848177313,"version":"4.3.4"},"reference-count":70,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2023,4,13]],"date-time":"2023-04-13T00:00:00Z","timestamp":1681344000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,5,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>This Clinical Practice Guideline addresses severe frostbite treatment. We defined severe frostbite as atmospheric cooling that results in a perfusion deficit to the extremities. We limited our review to adults and excluded cold contact or rapid freeze injuries that resulted in isolated devitalized tissue. After developing population, intervention, comparator, outcomes (PICO) questions, a comprehensive literature search was conducted with the help of a professional medical librarian. Available literature was reviewed and systematically evaluated. Recommendations based on the available scientific evidence were formulated through consensus of a multidisciplinary committee. We conditionally recommend the use of rapid rewarming in a 38 to 42\u00b0C water bath and the use of thrombolytics for fewer amputations and\/or a more distal level of amputation. We conditionally recommend the use of \u201cearly\u201d administration of thrombolytics (\u226412 hours from rewarming) compared to \u201clater\u201d administration of thrombolytics for fewer amputations and\/or a more distal level of amputation. No recommendation could be formed on the use of vascular imaging studies to determine the use of and\/or the time to initiate thrombolytic therapy. No recommendation could be formed on the use of intravenous thrombolytics compared to the use of intra-arterial thrombolytics on fewer amputations and\/or a more distal level of amputation. No recommendation could be formed on the use of iloprost resulting in fewer amputations and\/or more distal levels of amputation. No recommendation could be formed on the use of diagnostic imaging modalities for surgical planning on fewer amputations, a more distal level of amputation, or earlier timing of amputation.<\/jats:p>","DOI":"10.1093\/jbcr\/irad022","type":"journal-article","created":{"date-parts":[[2023,4,13]],"date-time":"2023-04-13T00:36:46Z","timestamp":1681346206000},"page":"541-556","source":"Crossref","is-referenced-by-count":27,"title":["American Burn Association Clinical Practice Guidelines on the Treatment of Severe Frostbite"],"prefix":"10.1093","volume":"45","author":[{"given":"Lucy","family":"Wibbenmeyer","sequence":"first","affiliation":[{"name":"Department of Surgery, University of Iowa , Iowa City, IA 52242 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5774-4444","authenticated-orcid":false,"given":"Alexandra M","family":"Lacey","sequence":"additional","affiliation":[{"name":"Department of Surgery, Regions Hospital , Saint Paul, MN 55101 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3321-3681","authenticated-orcid":false,"given":"Frederick W","family":"Endorf","sequence":"additional","affiliation":[{"name":"Department of Surgery, Hennepin Healthcare , Minneapolis, MN 55415 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1389-0527","authenticated-orcid":false,"given":"Sarvesh","family":"Logsetty","sequence":"additional","affiliation":[{"name":"Departments of Surgery, Psychiatry, and Children\u2019s Health, University of Manitoba , Winnipeg, Manitoba R3E 3P5 , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3644-6755","authenticated-orcid":false,"given":"Anne L L","family":"Wagner","sequence":"additional","affiliation":[{"name":"Department of Surgery, Vanderbilt University Medical Center , Nashville, TN 37212 , 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