Treatment of experimental frostbite with urokinase.

An experimental model of frostbite using a standard cold injury in rats was used to test the therapeutic usefulness of the fibrinolytic agent urokinase. Control groups included rapid rewarming, slow rewarming, and slow rewarming followed by saline infusion. Urokinase was administered through an intra-arterial catheter 30 minutes after cold injury and slow rewarming. Optimum results were obtained with rapid rewarming of the extremity at 43 degrees C. However, with rewarming at room temperature eventual tissue loss was significantly decreased with the infusion of urokinase compared with either no treatment or saline infusion. In the clinical situation where the patient with frostbite is seen after slow rewarming, we believe that clinical trials of the use of a fibrinolytic agent are warranted.