Cryoinjury with compartment syndrome of bilateral hands secondary to Freon gas: a case report and review of current literature

Freon is an industrial refrigerant that can result in serious cryoinjury of the skin. Although there had been a few reported cases, the optimal management is not clear. We present the first case report of a patient with freon-induced cryoinjury of bilateral hands, complicated with compartment syndrome and treated with a combination of surgical decompression, negative-pressure wound therapy (NPWT), and hyperbaric oxygen therapy (HBOT). On follow-up, there was a complete healing without tissue loss or significant atrophy of the intrinsic muscles of the hand. Therefore, we opined that HBOT and NPWT may work synergistically to prevent progressive tissue damage and improve the long-term outcome, especially when vascularity is compromised in severe cryoinjuries of the hand. Level of Evidence: Level V, therapeutic study.