A blood clot-dissolving medication - tissue plasminogen activator (tPA) -administered to some patients following a stroke or heart attack may help to reduce the risk of amputation following severe frostbite.

Preliminary research findings (led by Kevin J. Bruen, M.D.) by a team in University of Utah (Salt Lake City) found that patients administered with tPA within 24 hours of severe frostbite injury has reduced percentage of amputation of the toes and fingers.

According to the study's authors:

Among the six patients who received tPA within 24 hours of injury, six of 59 (10 percent) affected fingers or toes were amputated, compared with 97 of 234 (41 percent) among those who did not receive tPA. Moreover, no proximal [closer to the body than the fingers or toes] amputations were required in the patients who received tPA within 24 hours in our series.

The control group underwent 14 proximal amputations, including five below the knee. The preservation of limbs, which maximizes patient functional outcome, is perhaps the greatest benefit conferred by use of tPA in frostbite injury."

Traditional therapy for severe frostbite consists of tissue rewarming, prolonged watchful waiting and often delayed amputation and has remained like such for the past 25 years.

The tPA study authors concluded that with theur promising findings, futher studies are most likely in order to determine the best methods of assessing tissue damage and administering thrombolytics [anti-clotting drugs] in terms of timing, duration and route.

Findings have been reported in the June issue of Archives of Surgery.

Read the full report at JAMA and Archives Journal and the LA Times.

[Photo Credit: NLM-NIH]