• Remco R Berendsen, Nikki E Kolfschoten, Vincent M de Jong, Herman Frima, Hein A M Daanen, and Helen A Anema.
• LUMC, Leiden, Afd. Anesthesiologie, the Netherlands. r.r.berendsen@lumc.nl
• Ned Tijdschr Geneeskd. 2012 Jan 1; 156 (25): A4702.

AbstractFrostbite injuries rarely occur in healthy Dutch persons. However, as the number of people engaging in winter and outdoor activities and travelling to high altitudes increases, the risk of frostbite also increases. Frostbite is a cold-induced injury which results from two processes: freezing and microvascular occlusion. Adequate first aid, which focuses on the prevention of refreezing and mechanical injury, and rapid rewarming together with the administration of ibuprofen, are of the greatest importance for limiting eventual tissue damage. Iloprost infusion and possibly (r)tPA are indicated if a patient presents within 24 hours after the tissue has thawed and the injury is such that severe morbidity can be expected. If the patient presents after this time period, hyperbaric oxygen therapy may be considered; however, the evidence available on this type of treatment is limited.

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