Hyperbaric oxygen treatment in deep frostbite of both hands in a boy

An 11-year-old boy in good general health conditions suffered deep frostbite on six fingers while he was working without gloves as a beater during a hunt in Poland at an outdoor temperature of −32°C over a 4 h-period. Three days later he was first seen by a physician who planned to amputate the affected fingers. The patient was transferred by his family to our University Hospital in Aachen, Germany. We found third degree frostbite on four fingers of the right and on two fingers of the left hand. Because of the late beginning of the therapy, the patient was treated by HBO2 according to the Marx-schema for problem wounds (2, 4 bar, total time at depth: 90 min, alternations of 100% O2 and air breathing). HBO2-treatment was repeated daily for 14 days. No adverse events were recorded during the course of therapy. A total recovery of the severe frostbite was observed after 14 days of HBO2-treatment. Twenty-eight months after the injury the patient reports fully regained sensibility and no pain. The plain X-ray after this period showed no premature closure of the epiphyses or sclerosis of the metaphyses. Conclusions: Because of the low risk associated with HBO2, and its potential therapeutic efficiency, HBO2 should be recommended as adjunct therapy in the treatment of deep frostbite.