Treatment with clot-buster drugs reduces the risk of amputation in frostbite injuries, if given within 24 hours of exposure. The clot-buster drug, tissue plasminogen activator (tPA) is usually used for clearing blood clots that cause heart attacks or strokes. It increases the amount of blood flowing in the affected tissues, and so may help prevent amputations due to frostbite. Researchers from the University of Utah in Salt Lake City conducted a study, in which 32 patients were identified with frostbite. Of these, fingers were involved in 19%, toes in 62% and involvement of both were seen in 19%. The outcomes of six tPA-treated patients were compared with those of 26 patients who received traditional treatment, which included rewarming, fluids, and wound care. The rate of amputation of fingers or toes in the conventional treatment group was 41 per cent, while the rate in the tPA group was 10 per cent. However, additional studies are warranted to confirm the findings and to determine the best methods of assessing tissue damage and administering (clot-dissolving agents) in terms of timing, duration, and route.
Archives of Surgery,
June 2007