{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T06:11:56Z","timestamp":1778825516194,"version":"3.51.4"},"reference-count":12,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T00:00:00Z","timestamp":1778803200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:p>The reconstructive salvage of a severely frostbitten hand in a tropical setting presents a unique challenge. We report a 59-year-old male who sustained extensive frostbite to the face, ears and bilateral hands following a Mount Everest ascent. Hyperbaric oxygen therapy (HBOT) was initiated during demarcation to optimise tissue viability. Following demarcation, dry gangrene of the right hand required amputation, revealing viable 1.5\u20132\u2005cm proximal phalangeal stumps in all five digits. To avoid a non-functional metacarpal hand, reconstruction aimed to preserve digital length and metacarpophalangeal joints. A staged abdominal pedicled flap was performed, with initial flap inset and delayed pedicle division at 3 weeks, followed by syndactyly release. At 10-month follow-up, secondary debulking and contracture release were performed to optimise prosthetic use. The patient achieved stable, partially sensate digital stumps with preserved length and joint motion. This case highlights a two-stage reconstructive approach integrating HBOT and an abdominal pedicled flap to maximise anatomical preservation and functional outcome in severe pan-digital frostbite.<\/jats:p>","DOI":"10.3389\/fsurg.2026.1829574","type":"journal-article","created":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T05:42:41Z","timestamp":1778823761000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Frostbite in the tropics: abdominal pedicled flap reconstruction to prevent the metacarpal hand"],"prefix":"10.3389","volume":"13","author":[{"given":"Adzim Poh Yuen","family":"Wen","sequence":"first","affiliation":[{"name":"Plastic Surgery Unit, Department of Surgery, Hospital Canselor Tuanku Muhriz UKM","place":["Kuala Lumpur, Malaysia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhun Shen","family":"Tan","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, National University of Malaysia","place":["Kuala Lumpur, Malaysia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kah Ken","family":"Kwan","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, National University of Malaysia","place":["Kuala Lumpur, Malaysia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed Nabil","family":"Mohamed Nazri","sequence":"additional","affiliation":[{"name":"Plastic Surgery Unit, Department of Surgery, Hospital Canselor Tuanku Muhriz UKM","place":["Kuala Lumpur, Malaysia"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shalimar","family":"Abdullah","sequence":"additional","affiliation":[{"name":"Hand & Microsurgery Unit, Department of Orthopaedics and Traumatology, Hospital Canselor Tuanku Muhriz UKM","place":["Kuala Lumpur, 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