A Photographic Case of Frostbite Treated with Delayed Hyperbaric Oxygen Therapy

Abstract

Davis, Ashlee, Brent Sinopoli, Nathaniel Mann, and Antine E. Stenbit. A photographic case of frostbite treated with delayed hyperbaric oxygen therapy. High Alt Med Biol. 23:194-197, 2022.-A 50-year-old female presented to the emergency department in June 2019 5 days after summiting Denali. Temperature on summit day was -25°F, and she developed frostbite on multiple digits of both hands. Eight digits demonstrated severe frostbite based on the grading set forth by Cauchy et al. Five of these had grade III injuries. She received three hyperbaric dives in Alaska before flying to her home state. On day 5 she received aspirin, aloe wraps, and underwent twenty-seven 90-minute dives at 2 atmospheres absolute. Unique in current literature, each dive was accompanied by photographs detailing clinical progression, which may assist providers in providing expectations in care. She eventually underwent amputation at, or distal to, the distal interphalangeals of bilateral third and fourth digits and the left fifth digit. By January 2020, she had returned to near-normal range of motion. Hyperbaric oxygen therapy represents a potential adjunct therapeutic option for frostbite, even in delayed manner, but its use as a treatment modality warrants further prospective analysis.

Keywords: case report; frostbite; hyperbaric oxygen; wilderness medicine.