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Protocoled thrombolytic therapy for frostbite improves phalangeal salvage rates

Burns & Trauma 2020年第1期8卷 338-346页

作者： Rosemary Elizabeth Paine Elizabeth Noel Turner daniel kloda Carolyne Falank Bruce Chung Damien Wilson Carter Department of Surgery Maine Medical Center22 Bramhall StPortlandMaine 04102USA Department of Radiology Maine Medical Center22 Bramhall StPortlandMaine 04102USA

Background:Frostbite is a cold injury that has the potential to cause considerable morbidity and long-term *** the complexity of these patients,diagnostic and treatment practices lack *** therapy has emerged as a promising treatment modality,demonstrating impressive digit salvage *** review our experience with thrombolytic therapy for severe upper extremity ***:Retrospective 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 intraarterial thrombolytic therapy(IATT)were ***:Of 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 *** demonstrated a 74.5%improvement in perfusion after tissue plasminogen activator *** 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 ***:Thrombolytic 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： Frostbite Tissue plasminogen activator Amputation Digit salvage Thrombolysis

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