deep frostbite the question of treatment

Abstract Within the spectrum of peripheral cold injuries, frostbite is the most serious lesion in many cases leading to the amputation of fingers or a limb. Frostbite is becoming increasingly prevalent due to an increase in outdoor activities such as skiing, hiking, and mountaineering, affecting fit, active individuals who are in the prime of their lives. The pathophysiology of frostbite is well characterized; it involves two main pathways: (a) intracellular changes that lead to cell death, (b) tissue ischemia and thrombus formation. Besides the recommendation of aggressive warming of the affected tissues, other adjuvant treatments administered in the post thawing stage have been suggested. Here we discuss the pathophysiology of frostbite, tools for assessment of injury severity and the current approaches on patient medical management in the field and during hospitalization. Keywords Cold related injuries; Frostbite; Hyperbaric Oxygen (HBO); Prostacyclin; Thrombolytic agents