What Researchers Did
Researchers reviewed the evidence on treatments for frostbite injuries, including drugs that widen blood vessels or dissolve clots.
What They Found
This Cochrane review found only one small randomized trial to include, an open-label study of 47 people with severe frostbite, and judged the overall evidence quality very low. In that trial, all participants got rapid rewarming, aspirin, and IV buflomedil, then were split into three groups: additional buflomedil, iloprost, or iloprost plus a clot-dissolving drug called rtPA. The trial reported fewer amputations with iloprost (relative risk 0.05) and with iloprost plus rtPA (relative risk 0.31) compared to buflomedil alone, but the review authors rated this very low-quality evidence and the trial was small and had a high risk of bias. No deaths or withdrawals due to side effects were reported in any group, though side effects like flushing, nausea, palpitations, and vomiting were common overall.
Canadian Relevance
No direct Canadian connection identified.
Study Limitations
The review is based on only one small, open-label trial with a high risk of performance bias, so the authors describe the evidence for any treatment benefit as very low quality and call for larger, higher-quality trials.