Evaluating the Efficacy of Hyperbaric Oxygen Therapy in Digital Frostbite




Presbyterian/St. Luke’s Medical Center

Document Type


Publication Date



Environmental Injury, Ischemia, Surgery, Wound


Podiatry | Surgery


Frostbite is a cold-induced tissue injury most commonly affecting the extremities, potentially leading to amputation. Hyperbaric oxygen therapy (HBOT) is a proposed adjunctive treatment for this condition which acts by increasing cellular oxygen availability in the damaged tissues. Currently, there is a lack of data regarding the effectiveness of HBOT in the literature. Therefore, the purpose of this study is to further the research as one of the largest retrospective comparative cohort studies to date. We evaluated the efficacy of HBOT in the treatment of digital frostbite compared to a non-HBOT-treated group, with a focus on amputation outcomes between each group. A multicenter retrospective cohort study was performed from January 2016 to August 2021 observing patients seen for frostbite. Amputation characteristics and encounter outcomes of patients treated with HBOT were compared to those in patients treated without HBOT. A one-to-one matching of HBOT-treated and non-HBOT-treated patients was also performed, followed by Chi-Square and Fisher's exact test statistical analysis. The results of the study found a low overall amputation rate of 5.2% across both cohorts. Comparison between groups identified no statistical difference between HBOT and non-HBOT groups regarding amputation characteristics through matched cohort analysis and very little difference in the unmatched groups. However, an increased length of hospital stay in patients treated with HBOT (22.2 days) compared to the non-HBOT group (6.39 days) was identified. Based on this study, recommendations for future HBOT studies should evaluate more severe cases of frostbite, with additional consideration for cost analysis studies.

Publisher or Conference

Journal of Foot and Ankle Surgery