Clinical course and management of extremity frostbite in populations under forced movement in border regions.
8 affiliations
- 1Department of General Surgery, Van Yüzüncü Yıl University Faculty of Medicine, Van-Türkiye.
- 2Department of Pediatric Surgery, Van Yüzüncü Yıl University Faculty of Medicine, Van-Türkiye.
- 3Department of Anatomy, Gaziantep University Faculty of Medicine, Gaziantep-Türkiye.
- 4Department of General Surgery, Van Training and Research Hospital, Van-Türkiye.
- 5Department of Orthopedics and Traumatology Surgery, Van Training and Research Hospital, Van-Türkiye.
- 6Department of General Surgery, İstanbul Provincial Directorate of Health Kartal Dr. Lutfi Kirdar City Hospital, İstanbul-Türkiye.
- 7General Surgery Clinic, Selahattin Eyyübi State Hospital, Diyarbakır-Türkiye.
- 8Department of General Surgery, University of Health Sciences, Gülhane Hospital, Ankara-Türkiye.
Abstract
Background
Frostbite is a serious cold injury that can progress to deep tissue damage and even amputation. The increasing number of cases among refugee and migrant populations who are forcibly mobile in border regions necessitates a detailed evaluation of clinical course and risk factors. This study aimed to assess the demographic characteristics, clinical course, laboratory findings, and treatment outcomes of patients presenting with frostbite-related extremity injuries.Methods
This retrospective study included a total of 154 patients who presented with a clinically confirmed diagnosis of frostbite. Patients were analyzed according to three predefined classifications: treatment approach (conservative, medical, advanced/interventional), anatomical distribution of frostbite involvement, and time to hospital presentation (≤12 h, 12-24 h, 24-36 h, 36-48 h, and >48 h). Demographic data, clinical findings, laboratory parameters, treatment modalities, and clinical outcomes were evaluated. Statistical analyses were performed using non-parametric tests and Chi-square analysis.Results
The median age of the patients was 23 years, and 94.2% were foreign nationals. The most common time to presentation was 12-24 h after cold exposure (61%). As the time to hospital admission increased, frostbite grade, number of affected extremities, frequency of hypotension, white blood cell (WBC) levels, and length of hospital stay increased significantly (p<0.001). Amputation was performed in 77.3% of patients, and all amputated cases had fourth-grade frostbite. Amputation was significantly associated with delayed presentation, hypotension, elevated WBC levels, larger frostbite area, and longer hospital stay (p<0.05).Conclusion
Delayed presentation and severe systemic involvement are the most important determinants of amputation risk. Early diagnosis, rapid and controlled rewarming, appropriate patient transfer, and timely access to advanced treatment options are critical for reducing amputation rates.
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BibTeX
@article{binici2026clinical,
title = {{Clinical course and management of extremity frostbite in populations under forced movement in border regions.}},
author = {Serhat Binici and Firat Aslan and Burhan Beger and Orhan Beger and Sevinç Mengi and Ali Riza Karayil and Ozan Okyay and Ibrahim Ozalp and Ferhat Danisman and Iklil Eryilmaz and Abdulselam Ozdemir and Mehmet Cetin Kotan and Mehmet Eryilmaz},
journal = {Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma \& emergency surgery : TJTES},
year = {2026},
month = oct,
doi = {10.14744/tjtes.2026.05773},
url = {https://europepmc.org/article/MED/42841885},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Clinical course and management of extremity frostbite in populations under forced movement in border regions.
AU - Serhat Binici
AU - Firat Aslan
AU - Burhan Beger
AU - Orhan Beger
AU - Sevinç Mengi
AU - Ali Riza Karayil
AU - Ozan Okyay
AU - Ibrahim Ozalp
AU - Ferhat Danisman
AU - Iklil Eryilmaz
AU - Abdulselam Ozdemir
AU - Mehmet Cetin Kotan
AU - Mehmet Eryilmaz
PY - 2026
DA - 2026/10/01
JO - Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES
DO - 10.14744/tjtes.2026.05773
UR - https://europepmc.org/article/MED/42841885
AB - Background Frostbite is a serious cold injury that can progress to deep tissue damage and even amputation. The increasing number of cases among refugee and migrant populations who are forcibly mobile in border regions necessitates a detailed evaluation of clinical course and risk factors. This study aimed to assess the demographic characteristics, clinical course, laboratory findings, and treatment outcomes of patients presenting with frostbite-related extremity injuries.Methods This retrospective study included a total of 154 patients who presented with a clinically confirmed diagnosis of frostbite. Patients were analyzed according to three predefined classifications: treatment approach (conservative, medical, advanced/interventional), anatomical distribution of frostbite involvement, and time to hospital presentation (≤12 h, 12-24 h, 24-36 h, 36-48 h, and >48 h). Demographic data, clinical findings, laboratory parameters, treatment modalities, and clinical outcomes were evaluated. Statistical analyses were performed using non-parametric tests and Chi-square analysis.Results The median age of the patients was 23 years, and 94.2% were foreign nationals. The most common time to presentation was 12-24 h after cold exposure (61%). As the time to hospital admission increased, frostbite grade, number of affected extremities, frequency of hypotension, white blood cell (WBC) levels, and length of hospital stay increased significantly (p<0.001). Amputation was performed in 77.3% of patients, and all amputated cases had fourth-grade frostbite. Amputation was significantly associated with delayed presentation, hypotension, elevated WBC levels, larger frostbite area, and longer hospital stay (p<0.05).Conclusion Delayed presentation and severe systemic involvement are the most important determinants of amputation risk. Early diagnosis, rapid and controlled rewarming, appropriate patient transfer, and timely access to advanced treatment options are critical for reducing amputation rates.
SN - 1306-696X
SN - 1307-7945
ER -