A Late Presented Fourth Degree Frostbite: A Challenging Experience in a Tropical Country

Abstract

Frostbite is a rare encounter for surgeons in tropical countries such as Sri Lanka. It is a severe form of cold exposure injury and has a challenging treatment protocol. We report a case of late presented fourth degree frostbite which had culminated in amputation. The purpose of this study is to highlight the surgical management of frostbite to healthcare professionals through our experience in treating this oddest case in our country. The patient was a Sri Lankan immigrant to Turkey and presented to us with bilateral gangrenous toes with delay in seeking medical care abroad. He underwent bilateral toe amputations and skin graft to wounds. Surviving frostbite starts in the field with maintaining adequate peripheral perfusion, appropriate rewarming, and timely surgical intervention along with supportive therapy. This case reinstates the necessity to be informed on the potential harms that can occur in a new climate zone. And displays the poor outcome of frostbite encountered due to time factor and the need of a well-trained medical team equipped to manage frostbite.