A Controlled Trial of a Prostacyclin and rt-PA in the Treatment of Severe Frostbite

Abstract

To the Editor: Many alternatives have been proposed for the treatment of frostbite: hemodilution, platelet-aggregation inhibitors, low-molecular-weight heparin, alpha-adrenergic vasodilators, calcium-channel inhibitors, nonsteroidal antiinflammatory agents, prostacyclin analogues, fibrinolytic agents, and hyperbaric oxygen. None have been assessed in prospective randomized trials. Small retrospective studies1–3 suggest the efficacy of thrombolysis or prostacyclin analogues against spasm and thrombosis. Between 1996 and 2008, we randomly assigned 47 patients (44 men and 3 women) with severe frostbite to one of three treatment regimens in an open-label study. Severe frostbite was defined as having at least one digit (finger or toe) with frostbite stage 3 . . .