An 11-year-old boy in good general health conditions suffered deep frostbit
e on six fingers while he was working without gloves as a beater during a h
unt in Poland at an outdoor temperature of - 32 degreesC 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 Univ
ersity 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 l
ate beginning of the therapy, the patient was treated by HBO, according to
the Marx-schema for problem wounds (2, 4 bar, total time at depth: 90 min,
alternations of 100% O-2 and air breathing). HBO2-treatment was repeated da
ily for 14 days. No adverse events were recorded during the course of thera
py. A. total recovery of the severe frostbite was observed after 14 days of
HBO2-treatment. Twenty-eight months after the injury the patient reports f
ully regained sensibility and no pain. The plain X-ray after;his period sho
wed no premature closure of the epiphyses or sclerosis of the metaphyses. C
onclusions: Because of the low risk associated with HBO2: and its: potentia
l therapeutic efficiency, HBO2 should be recommended as adjunct therapy in
the treatment of deep frostbite. (C) 2001 Elsevier Science Ltd and ISBI. Al
l rights reserved.