Pedicled Abdominal Flaps for Enhanced Digital Salvage After Severe Frostbite Injury

Extremities are the area of the body most commonly affected by frostbite, which can also affect the face, ears, perineum, or genitals. Optimum management has moved away from early amputation and debridement toward maximizing tissue preservation and delaying surgical intervention. Increasing length of digit amputation increases morbidity, in terms of loss of hand function, experienced by patients. Reconstruction of affected digits is limited by bone necrosis, which often leads to shortened residual stumps and limited functional outcomes. This case describes the management of a severe frostbite injury affecting both hands and feet in a 39-y-old man, sustained during descent of Mount Everest. The use of a pedicled abdominal flap to provide soft-tissue cover permitted optimized digit length and function and sensate digits. The case highlights the benefits of early multidisciplinary team involvement in the management of severe frostbite to optimize functional outcome.