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Objective: To determine the efficacy of tissue plasminogen activator (tPA) therapy in reducing the number of limb and digit amputations in patients with severe frostbite.
Introduction: Current treatment regimens for frostbite consist mainly of rapid rewarming measures and wound care. This regimen is unfortunately many times not sufficient in cases of severe frostbite and frequently leads to delayed amputations.
Methods: A search was conducted in Pubmed using the terms "Frostbite"[Mesh]) AND "Tissue Plasminogen Activator"[Mesh]. Articles were chosen based on relevancy to the research question and having a publication date after 2005. Case reports were excluded.
Results: All three studies reported a decrease in incidence of amputation from severe frostbite in those who received tPA. When combining the results among the studies, the total number of at-risk digits was 259 when looking at the patients who received tPA. Of those 259 digits, 189 were salvaged after tPA use, leading to an overall salvage rate of 73%.
Conclusion: TPA therapy shows potential as a new and promising treatment of severe frostbite for a specific subset of patients. If specific measures are met, the benefits seem to outweigh the risks. That being said, further studies are warranted to solidify these results and prove efficacy.
Gravatt K, Mahen M. Effectiveness of tPA at Reducing Amputations in Patients with Severe Frostbite. Posted online December 16, 2021.