Journal article
Thrombolytic Use in Management of Frostbite Injuries: Eight Year Retrospective Review at a Single Institution
Journal of burn care & research, Vol.41(3), pp.722-726
05/01/2020
DOI: 10.1093/jbcr/iraa028
PMID: 32030427
Abstract
Frostbite injuries are uncommon, understudied, and lack standardized treatment protocols. Although thrombolytics are commonly used, their efficacy remains controversial. Herein, we report the results of a retrospective review of frostbite treatment practices at a single institution. The impact of thrombolytics on outcomes was evaluated. Medical records of frostbite patients admitted between January 2010 and April 2018 were reviewed. Demographics, injury details, treatment, and outcomes were collected. Descriptive statistics were obtained. A case-control analysis comparing patients who received tissue plasminogen activator (tPA) with those who did not was performed. A total of 102 patients were included. The mean age was 43 +/- 17.7; 82.4% were male. About 13% of patients were presented with first-degree, 54% with second-degree, 29% with third-degree, and 5% with fourth-degree frostbite. Toes (69%), fingers (53%), and feet (43%) were most commonly affected. Thirteen patients had angiograms. Twelve patients received tPA: three systemic tPA and nine catheter-directed tPA. Overall, 32 patients (31%) required surgery and 27 (26.5%) patients required amputation with an average of 6.5 digits amputated. Digit salvage rate based on angiography was 84.7%. Length of stay (P = .046), number of operations (P = .037), and need for surgery (P = .030) were significantly lower for patients who received thrombolytics. Two patients had bleeding complications but did not require intervention or interruption of therapy. Despite its small sample size, our study suggests benefits from thrombolytic therapy. Prospective, well designed, and multi-institutional studies are warranted to establish evidence-based treatment guidelines for the management of frostbite injuries.
Details
- Title: Subtitle
- Thrombolytic Use in Management of Frostbite Injuries: Eight Year Retrospective Review at a Single Institution
- Creators
- Jason Heard - Department of SurgeryAlan Shamrock - University of IowaColette Galet - Department of SurgeryKate O. Pape - Department of Pharmaceutical CareSandeep Laroia - University of IowaLucy Wibbenmeyer - Department of Surgery
- Resource Type
- Journal article
- Publication Details
- Journal of burn care & research, Vol.41(3), pp.722-726
- DOI
- 10.1093/jbcr/iraa028
- PMID
- 32030427
- NLM abbreviation
- J Burn Care Res
- ISSN
- 1559-047X
- eISSN
- 1559-0488
- Publisher
- Oxford Univ Press
- Number of pages
- 5
- Language
- English
- Date published
- 05/01/2020
- Academic Unit
- Radiology; Surgery; Injury Prevention Research Center; Internal Medicine
- Record Identifier
- 9984318815102771
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