Kemper TC, de Jong VM, Anema HA, van den Brink A, van Hulst RA, et al.
Undersea & hyperbaric medicine : journal of the Undersea and Hyperbaric Medical Society, Inc. Date of publication 2014 Jan 1;volume 41(1):65-70.
1. Undersea Hyperb Med. 2014 Jan-Feb;41(1):65-70.
Frostbite of both first digits of the foot treated with delayed hyperbaric
oxygen:a case report and review of literature.
Kemper TC, de Jong VM, Anema HA, van den Brink A, van Hulst RA.
BACKGROUND: Frostbite is an uncommon event that can occur from exposure to
temperatures below -4 degrees C and can lead to potential serious tissue damage
and necrosis. This in turn can result in debilitating amputations in otherwise
healthy people. The pathophysiological mechanisms of frostbite have marked
similarities to those seen in thermal burns, ischemia/reperfusion injuries and
crush injuries--i.e., non-healing wounds and inflammatory processes. These
injuries are commonly treated with hyperbaric oxygen therapy.
OBJECTIVES: Evidence for treating frostbite with hyperbaric oxygen (HBO2) is
scarce, and to date HBO2 is not a standard addition in the multidisciplinary
care of freezing injuries. We aim to contribute to the available evidence with a
case report and review the literature to reassess the multidisciplinary
treatment of frostbite injuries.
CASE REPORT AND REVIEW OF LITERATURE: We present a case report of a woman with
deep frostbite of the toes treated with hyperbaric oxygen therapy, after a delay
of 21 days, with good results. No surgical intervention was needed. A literature
search revealed 17 human case reports on frostbite and four animal studies in
which hyperbaric oxygen was applied. All case reports showed positive effects,
and in none of the cases was amputation necessary. In the animal studies, two
showed significant positive results regarding tissue loss and reduction of
inflammatory markers, whereas two did not.
CONCLUSIONS: Based on our case report as well as the literature and the
mechanisms of hyperbaric oxygen, we make the recommendation that this therapy be
considered as an addition to the multidisciplinary treatment of frostbite, even
after significant delay of treatment.
PMID: 24649719 [Indexed for MEDLINE]
