What Researchers Did
Researchers at a high-volume burn center reviewed 214 patients with severe frostbite over seven years (2013–2020), including 62 who received HBOT, to assess its impact on tissue survival and amputation rates.
What They Found
Patients who received HBOT had more severe initial injuries, they were more likely to receive clot-dissolving drugs (thrombolytics) and had larger areas of tissue damage. A significantly larger proportion of HBOT-treated patients required surgical intervention including amputation and debridement, reflecting their higher initial injury severity rather than HBOT failure. Patient age, injury severity, and thrombolytic use all significantly influenced outcomes.
What This Means for Canadian Patients
Frostbite is a real and serious risk for Canadians who work outdoors, participate in winter sports, or experience homelessness. This study does not show that HBOT worsens outcomes, it shows HBOT was used for the most severe cases. Canadians with severe frostbite, especially when clot-dissolving drugs are not an option, should ask about HBOT as an additional treatment.
Canadian Relevance
No direct Canadian connection identified. Frostbite is not an OHIP-covered indication for HBOT in Ontario, though it is recognized by the Undersea and Hyperbaric Medical Society guidelines.
Study Limitations
Severely injured patients were more likely to receive HBOT, creating a selection bias that makes it impossible to assess HBOT's independent effect without a randomized controlled trial.