Thrombolytic therapy has recently emerged as a treatment modality to potentially improve outcomes in severe frostbite. A growing body of evidence suggests that administering thrombolytic agents such as tissue plasminogen activator (tPA) early in treatment can save digits and limit the extent of subsequent amputation. Practitioners of many specialties have long been frustrated by the lack of effective treatment options for this age-old problem. The hand surgeon is frequently consulted with little to offer other than local wound care, serial clinic visits, and ultimately, digit amputation. Thrombolytic therapy is currently evolving as a treatment approach to manage severe cold injury, and it has shown promise in decreasing rates of digital amputation. Considering the functional impairment sustained from the loss of frostbitten fingers, this issue is particularly pertinent for the consulting hand surgeon.
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Accepted: January 8, 2009
Received: October 12, 2008
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
© 2009 Published by Elsevier Inc.