The emerging role of tissue plasminogen activator in the management of severe frostbite

This article presents a small case series demonstrating clinical success with thrombolytic agents for severe frostbite injury to the lower extremities. The authors report three patients with severe frostbite injuries to their distal lower extremities who were managed with urgent interventional radio...

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Bibliographic Details
Published inJournal of burn care & research Vol. 36; no. 2; p. e62
Main Authors Ibrahim, Amir E, Goverman, Jeremy, Sarhane, Karim A, Donofrio, Jill, Walker, T Gregory, Fagan, Shawn P
Format Journal Article
LanguageEnglish
Published England 01.03.2015
Subjects
Adult
Fibrinolytic Agents - administration & dosage
Fingers - blood supply
Fingers - diagnostic imaging
Frostbite - diagnostic imaging
Frostbite - drug therapy
Humans
Infusions, Intravenous
Male
Middle Aged
Radionuclide Imaging
Tissue Plasminogen Activator - administration & dosage
Toes - blood supply
Toes - diagnostic imaging
Treatment Outcome
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Summary:This article presents a small case series demonstrating clinical success with thrombolytic agents for severe frostbite injury to the lower extremities. The authors report three patients with severe frostbite injuries to their distal lower extremities who were managed with urgent interventional radiology and intra-arterial tissue plasminogen activator infusion according to a prespecified protocol. Limbs and digits were successfully salvaged and patients returned to normal activity within 2 weeks. Although further studies are needed, results of this study support a new approach in the management of frostbite: from conservative management and observation to urgent interventional radiology and possible tissue plasminogen activator infusion. A protocol for the management of such injuries is presented.
ISSN:1559-0488
DOI:10.1097/BCR.0000000000000135