Localized low-temperature exposure in medicine: classification, evolution of approaches, and clinical areas of application

Localized low-temperature exposure comprises medical technologies based on controlled heat removal from a limited tissue region and differing in clinical purpose and biological outcome. The aim of this review was to refine the terminology, compare the main directions of localized low-temperature exposure, trace the evolution of approaches, and analyze current clinical fields of application. An analytical review of Russian and international publications indexed in RISC, PubMed/MEDLINE, Scopus, Web of Science, and Google Scholar was performed. The review shows that modern cryomedicine should distinguish three independent directions of localized low-temperature exposure: destruction, preservation, and therapy. These directions share the same thermal basis but differ in their intended biological outcome, acceptable temperature range, cooling depth, exposure duration, and criteria of effectiveness. Current research is focused on standardizing temperature-time protocols, improving navigation and computational support, personalizing cooling, and evaluating clinical outcomes in minimally invasive treatment, transplantation, medical rehabilitation, and restorative medicine. The proposed systematization may serve as a basis for clinically oriented description and further standardization of the cold factor in medicine, including medical rehabilitation, restorative treatment, and conditions associated with limited functional activity.

Contributions:
Korobova N.Yu. — concept and design of the review, literature search and analysis, systematization of the material, writing of the manuscript;|
Makarov A.F. — concept of the review, scientific editing, critical revision of the content;
Pushkarev A.V. — literature search and analysis, drafting of selected sections of the manuscript, editing;
Shakurov A.V. — literature analysis, participation in data interpretation, editing of the manuscript;
Tsiganov D.I. — scientific supervision, critical revision of the manuscript, approval of the final version of the article.

Funding. The study was supported by grants from the Russian Science Foundation (RSF), № 24-79-10153, https://rscf.ru/project/24-79-10153/ (section on local low-temperature exposure for therapeutic purposes) and № 24-19-00497, https://rscf.ru/project/24-19-00497/ (sections of local low-temperature exposure for the purpose of destruction and preservation of biological tissues).

Conflict of interest. The authors declare no conflict of interest.

Received: 29.04.2026 / Accepted: 01.05.2026 / Published: 02.06.2026

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