Comments on “The Use of tPA in the Treatment of Frostbite: A Systematic Review”

Abstract

We have read with interest the recently published article "The use of tPA in the Treatment of Frostbite: A systematic Review" by Dr. Richard Hutchison et al published in the January 2019 issue. 1 We applaud them for their efforts to study this difficult problem and agree with much of their findings. However, we believe their final recommendation to avoid the use of thrombolytics in frostbite patients unless conducting in an active research protocol may be misleading to readers. We have found thrombolysis to be an effective means of limb salvage for severe frostbite at our institution, which is a tertiary referral center evaluating numerous frostbite victims annually. (Figure 1) We believe their findings might dissuade others from attempting thrombolytic ther-850629H ANXXX10.