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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References
- An open-label study to evaluate the safety and efficacy of tissue plasminogen activator in treatment of severe frostbite.J Trauma. 2005; 59 (discussion 1354–1355): 1350-1354
- Reduction of the incidence of amputation in frostbite injury with thrombolytic therapy.Arch Surg. 2007; 142 (discussion 551–543): 546-551
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- Experimental and clinical observations on frostbite.Ann Emerg Med. 1987; 16: 1056-1062
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Article info
Publication history
Accepted:
January 8,
2009
Received:
October 12,
2008
Footnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2009 Published by Elsevier Inc.
