Heparin Formulation Aids On-Site Management of Frostbite Injury

A novel nano-spray gel (NSG) formulation, which is based on a combination of liposomal heparin sodium and ibuprofen, provides rapid relief of frostbite injury in extremely low temperatures.

Developed by researchers at the Institute of Nano Science and Technology (INST; Mohali, India), Panjab University (Chandigarh, India), and other institutions, the NSG is a sprayable hydrogel based on heparin packaged into liposomes, lipid carriers that help to deliver the formulation deep into the skin. The liposomes also contain ibuprofen and propylene glycol, which help keep the spray from freezing at very low temperatures. A single spray puff of NSG delivers about 154 mg of the gel, which corresponds to around 205 U of heparin.

In a study of the spray gel on Sprague Dawley rats with frostbite injury, the researchers found that the treatment completely healed frostbite injuries within 14 days, whereas untreated injuries were only about 40% healed, and frostbite wounds treated with an antibiotic cream were about 80% healed. The spray also reduced levels of inflammatory cytokines (IL-6, TNF-α, IL-10, IL-4) at the wound site and in the blood circulation, which accelerated the healing process. The study was published on December 9, 2019, in ACS Biomaterials Science & Engineering.

“The critical time window between the incidence of frostbite injury and the initiation of treatment in remote snowbound areas is a determining factor for an effective therapeutic response,” concluded lead author Kalpesh Vaghasiya, MsPharm, of INST, and colleagues. “The instant on-site application of this formulation might be helpful in saving extremities of soldiers, mountaineers, and pilgrims having frostbite.”

Frostbite causes fluids in the skin and the underlying dermal tissues to freeze and crystallize, resulting in inflammation, decreased blood flow, and cell death. Extremities are the most affected areas, because they are farther away from the body's core. If frostbite is not treated promptly, it can lead to gangrene and amputation of the affected limbs. Conventional treatments include immersing the body part in warm water, applying topical antibiotic creams, or administering vasodilators and anti-inflammatory drugs, but many of these are unavailable in isolated snowy areas, like mountaintops. Other options, such as topical medications, could end up freezing themselves.

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