Yukon doctor hopes to take sting out of frostbite

Whitehorse General Hospital general surgeon Dr. Alex Poole and local pharmacist Josianne Gauthier have brought a new treatment for frostbite to the Yukon.

Whitehorse General Hospital general surgeon Dr. Alex Poole and local pharmacist Josianne Gauthier have brought a new treatment for frostbite to the Yukon.

The treatment is designed for use in patients with severe frostbite and involves combining the standard technique of rapidly rewarming affected areas with the drug iloprost. Iloprost is used to treat pulmonary arterial hypertension — a form of high blood pressure which affects arteries linking the heart and the lungs.

“The iloprost dilates the blood vessels … so we’re basically using it to reopen the blood vessels as we rewarm the skin to prevent fingers and toes from dying,” Poole said.

When frostbite occurs, the blood vessels in the affected tissues contract and spasm when they warm up. That can cause severe tissue damage through inflammation and clotting. At its worst, this process can ultimately require amputation, Poole said. Fingers and toes are especially susceptible.

Two Yukon Arctic Ultra runners who had suffered severe frostbite were treated using this method at WGH over the course of two months. Both patients recovered without amputation and with minimal long-term effects from their injuries. The results were published as a case study in the December 2016 issue of the Canadian Medical Association Journal.

The treatment would later be used on six more patients, all Yukoners, who would recover similarly, said Poole.

The combination treatment can reduce the risk of amputations in patients with severe frostbite by up to 50 per cent, he said.

Poole said this combination treatment is more effective than rewarming alone, but it’s not a cure-all. Poole said people who think they might have frostbite should take proper care of their injuries, rewarming the affected area if possible in a tub and then seeking medical attention.

One danger of frostbite is that it can take time for people to realize how seriously they’ve been injured, Poole said. “Initially, frostbite may not look like much, just grey or pale skin … progressing to grey blisters and rawness and then blackened fingers or toes,” he said. “That black flesh means the digits have died.”

The treatment is new to North America but common in Europe, where iloprost is approved for sale. The drug is not approved for use in Canada and Poole and Gauthier had to get special permission from the federal government to import and use the drug in the Yukon. They have to order the drug in limited quantities, but are allowed to keep some in stock, Poole said.

“This treatment has caused a firestorm (in North America) now that we’ve used it,” he said. “Everyone is asking themselves why we weren’t doing it before.”

The Yukon sees two to three cases of severe frostbite a year, Poole said. Clinics will also be stocking the drug in Watson Lake and Dawson City.

Contact the Yukon News at editor@yukon-news.com

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