Frostbite: diagnosis, treatment, prognosis, and future directions

Noor Obaidi; Olivia Agee; Irene Yau; Robert Moritz; Kristo Nuutila

doi:10.1016/j.mmr.2026.100007

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Frostbite: diagnosis, treatment, prognosis, and future directions

REVIEW | Updated：2026-05-11

- Frostbite: diagnosis, treatment, prognosis, and future directions
- Military Medical Research (2026)
- Affiliations：
  
  The Metis Foundation, San Antonio, TX, 78216, USA
  General Surgery, William Beaumont Army Medical Center, Fort Bliss, TX 79906, USA
  United States Army Institute of Surgical Research, Fort Sam Houston, TX 78234, USA
- Author bio：
  
  *Kristo Nuutila, kristo.j.nuutila.ctr@health.mil
- Funds：
- DOI：10.1016/j.mmr.2026.100007
  CLC：
- Received：24 September 2025，
  
  Revised：2026-03-06，
  
  Published：2026-03
- Accepted：
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Obaidi N, Agee O, Yau I, Moritz R, Nuutila K. Frostbite: diagnosis, treatment, prognosis, and future directions. Mil Med Res. 2026;13(1):100007.
DOI：

Obaidi N, Agee O, Yau I, Moritz R, Nuutila K. Frostbite: diagnosis, treatment, prognosis, and future directions. Mil Med Res. 2026;13(1):100007. DOI： 10.1016/j.mmr.2026.100007.

摘要

Abstract

From cold-weather training to deployments in high altitude and arctic conditions

frostbite injury and its sequelae remain a serious concern in military operations. Frostbite harms tissue in two distinct ways. The first involves ice crystal formation within tissue

resulting in mechanical damage and ischemia. The second occurs secondary to the inflammatory and prothrombotic state caused by reperfusion from rewarming frozen tissue. Frostbite injuries can be classified in a number of ways

but no perfect system exists. Initial work-up and diagnosis are primarily clinical. However

in equipped treatment facilities

advanced imaging modalities such as technetium-99m (

99m

Tc) bone scintigraphy

magnetic resonance angiography

single-photon emission computed tomography/computed tomography (SPECT/CT)

and more can play a role in diagnosis and treatment. In resource-constrained environments

such as the deployed setting

management should involve an algorithmic approach. After concurrent hypothermia and/or trauma have been evaluated for and treated

active rewarming should take place so long as there is no risk of refreezing. During re-warming

surgical consultation

and evacuation considerations should be considered. Once evacuated to a definitive treatment facility

thrombolytic as well as other therapies may be indicated. Unless there is evidence of severe damage or infection

surgical management is typically delayed until injury margins are fully demarcated. Longer-term prognosis is dependent on severity

with deeper injuries often resulting in longer hospital stays

more amputations

and chronic disability. Looking forward

future frostbite research should aim to bridge field and hospital care with the goal of minimizing tissue loss and accelerating functional recovery.

关键词

Keywords

references

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