Hyperbaric oxygen therapy in frostbite: A case series

Abstract

A team of 10 personnel from a mountaineering team has undertaken an expedition to Mt Menthosa at an altitude of 21138 ft. in October 2018. After scaling the peak and in the following days during descent, the three members of the team had developed cold injuries. They were given first aid during descent. Later, they were diagnosed as cases of frostbite. All three personnel were evacuated to a Military Hospital, Delhi, India and were treated with oral vasodilators, antiplatelet drugs, analgesics, and hyperbaric oxygen therapy (HBO2T) was administered at a Recompression chamber at Delhi for 1 week. These personnel were thereafter referred to INHS Asvini for further management and continuation of HBO2T. After 30 sessions of HBO2T administration at this hospital, there was a significant improvement in the wounds of all three personnel with minimal surgical intervention and no major amputation. The treatment of frostbite includes treating hypothermia before thawing of cold injury, nonsteroidal anti-inflammatory drugs, antibiotics, tissue plasminogen activators and iloprost, a potent vasodilator which is used in severe cases. Planning of surgery is vital with the goal of obtaining the best functional outcome. Premature amputation increases morbidity and is likely to lead to poor subsequent function. This article aims to discuss the advantages of HBO2T administration as an adjuvant therapy in the management of frostbite cases along with wound care management.

Keywords

• frostbite
• hyperbaric oxygen therapy
• military wounds