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Hyperbaric Oxygen Therapy (HBOT) in the Treatment of Deep Frostbite

Frostbites are injuries that occur as a result of exposure to extremely low temperatures mostly below 0°C. They are attributed to a relatively high proportion of morbidity for individuals living in cold regions. The tissue exposed to the cold freezes thus resulting in injury. What ensues is tissues experiencing different levels of damage and necrosis are left unattended. Frostbite affects microcirculation therefore essentials don’t get to the body parts at the edges. Of all body parts, limbs are the most affected. Some of the predisposing factors that contribute to frostbite include ailments, habits such as smoking and alcoholism, poor fitness levels, and prolonged exposure to cold in the past. Several body parts are affected whenever frostbite strikes: muscles, bones, and subcutaneous, and dermal layers of the skin. Upon experiencing frostbite, one feels numb accompanied by a tingling feeling. If the situation is not attended to promptly, there is evidence of nerve injury since the receptors located on the superficial level have been sabotaged. Sensation reduces while increased sweating increases. 

How HBOT works

HBOT also boosts immunity such that the tissues do not suffer much after thawing occurs; there are minimal chances of pathogenic infection of the affected tissues. Essential supplies meant to reach the tissues are not affected much thus reducing the chances of ischemia-reperfusion injury from occurring. Tissue oxygenation also prevents secondary cell death thus reducing instances of such corrective phenomena as amputation and surgery; viable tissues are saved in good time. Most toes and fingers are salvaged with the introduction of HBOT. HBOT also aids in lowering inflammation associated with frostbite. One of the ways in which this is enabled is through increased microcirculation. With increased microcirculation, quantities of lipids and proteins within the cells are kept at the right proportions to prevent the cells from succumbing to the pressure of the extracellular ice crystals. Optimal PH and electrolyte portions within the cells affected by the extremely low temperatures are also maintained at optimal levels upon introduction of the reactive oxygen species (ROS). HBOT reverses the cellular damage and subsequent cell death caused by frostbite. The cellular membranes are kept supple and with an ample supply of essentials to prevent osmosis from happening. This makes it difficult for extracellular ice crystals to form and try to cross the cell membrane. Wound healing is initiated and subsequent tissue necrosis is eliminated in the process. Reducing inflammation as a result of tissue oxygenation also results in reduced edema. Tissue oxygenation deems tissue viable as it is enabled to perform all metabolic processes. Also, HBOT places clarity on the scenario by setting apart the viable from non-viable tissue. Overall, HBOT is preferred due to its low-risk nature as well as its resilience, as long as the patient attends all their sessions.


Dwivedi, D. A., Alasinga, S., Singhal, S., Malhotra, V., & Kotwal, A. (2015). Successful treatment of frostbite with hyperbaric oxygen treatment. Indian Journal of Industrial Medicine, 19(2), 121.

Ghumman, A., St Denis-Katz, H., Ashton, R., Wherrett, C., & Malic, C. (2019). Treatment of frostbite with hyperbaric oxygen therapy: a single center’s experience of 22 cases. PubMed, 31(12), 322–325.

Lansdorp, C. A., Roukema, G. R., Boonstra, O., Dokter, J., & Van Der Vlies, C. (2017). Delayed treatment of frostbite with hyperbaric oxygen: a report of two cases. Undersea & Hyperbaric Medicine, 44(4), 365–369.






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