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Typically used to treat acute ischemic stroke and ST-segment elevation myocardial infarction, tissue plasminogen activator (t-PA) can also help restore blood flow to frostbitten hands and feet. In a new study, researchers compared six people with frostbite who received intra-arterial t-PA within 24 hours of injury to 25 similar patients who didn't receive t-PA. Six of 59 frostbitten fingers and toes (10%) were amputated in the six people who received t-PA. In the group that didn't get t-PA, 97 of 234 frostbitten digits were amputated (41%).


The findings are the first clinically significant advancement in treating frostbite in more than 25 years. However, the researchers caution that the treatment isn't appropriate for everyone: t-PA could cause serious bleeding in some patients, including those with head injuries and those taking an anticoagulant such as warfarin.


Source: Bruen KJ, et al., Reduction of the incidence of amputation in frostbite injury with thrombolytic therapy, Archives of Surgery, June 2007.