Protocoled thrombolytic therapy for frostbite improves phalangeal salvage rates

Rosemary Elizabeth Paine; Elizabeth Noel Turner; Daniel Kloda; Carolyne Falank; Bruce Chung; Damien Wilson Carter

doi:10.1093/burnst/tkaa008

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Protocoled thrombolytic therapy for frostbite improves phalangeal salvage rates

更新时间：2022-06-09

- Protocoled thrombolytic therapy for frostbite improves phalangeal salvage rates
- Burns & Trauma Vol. 8, Issue 1, (2020)
- 作者机构：
  
  1. Department of Surgery
  2. Department of Radiology
- 作者简介：
- 基金信息：
- DOI：10.1093/burnst/tkaa008
  CLC：
- Published：2020，
  
  Published Online：10 April 2020，
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Rosemary Elizabeth Paine, Elizabeth Noel Turner, Daniel Kloda, Carolyne Falank, Bruce Chung, Damien Wilson Carter, Protocoled thrombolytic therapy for frostbite improves phalangeal salvage rates, Burns & Trauma, Volume 8, 2020, tkaa008, https://doi.org/10.1093/burnst/tkaa008
DOI：

Rosemary Elizabeth Paine, Elizabeth Noel Turner, Daniel Kloda, Carolyne Falank, Bruce Chung, Damien Wilson Carter, Protocoled thrombolytic therapy for frostbite improves phalangeal salvage rates, Burns & Trauma, Volume 8, 2020, tkaa008, https://doi.org/10.1093/burnst/tkaa008 DOI：

摘要

Abstract

BackgroundFrostbite is a cold injury that has the potential to cause considerable morbidity and long-term disability. Despite the complexity of these patients

diagnostic and treatment practices lack standardization. Thrombolytic therapy has emerged as a promising treatment modality

demonstrating impressive digit salvage rates. We review our experience with thrombolytic therapy for severe upper extremity frostbite.MethodsRetrospective data on all frostbite patients evaluated at our institution from December 2017 to March 2018 was collected. A subgroup of patients with severe frostbite treated with intra-arterial thrombolytic therapy (IATT) were analysed.ResultsOf the 17 frostbite patients treated at our institution

14 (82%) were male and the median age was 31 (range: 19–73). Substance misuse was involved in a majority of the cases (58.8%). Five (29.4%) patients with severe frostbite met inclusion criteria for IATT and the remaining patients were treated conservatively. Angiography demonstrated a 74.5% improvement in perfusion after tissue plasminogen activator thrombolysis. When comparing phalanges at risk on initial angiography to phalanges undergoing amputation

the phalangeal salvage rate was 83.3% and the digit salvage rate was 80%. Complications associated with IATT included groin hematoma

pseudoaneurysm and retroperitoneal hematoma.ConclusionsThrombolytic therapy has the potential to greatly improve limb salvage and functional recovery after severe frostbite when treated at an institution that can offer comprehensive

protocoled thrombolytic therapy. A multi-center prospective study is warranted to elucidate the optimal treatment strategy in severe frostbite.

关键词

Keywords

FrostbiteTissue plasminogen activatorAmputationDigit salvageThrombolysis

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