Erythromycin extravasation mimicking necrotising fasciitis in the infant

Harb, Ayad; Sawyer, Adam; Pandya, Aditya

doi:10.1007/s00238-010-0401-0

Cited by 2 publications

(13 citation statements)

References 2 publications

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“…First aid interventions, as shown in Figure 2a , were identified in 26 studies. 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 Stopping the IV and removal was the most common intervention, 16 , 17 , 18 , 19 , 22 , 23 , 25 , 26 , 28 , 29 , 30 , 31 , 34 , 35 followed by elevation 16 , 17 , 19 , 20 , 21 , 24 , 25 , 26 , 28 , 29 , 31 , 32 and compression. 17 , 27 , 29 , 31 ,…”

Section: Resultsmentioning

confidence: 99%

“…Surgical interventions, as shown in Figure 2c , were utilized in 22 studies. 16 , 17 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 27 , 28 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 40 , 41 , 42 Surgical puncture 17 , 21 , 22 , 23 , 25 , 28 , 30 , 31 , 33 , 35 , 37 , 40 , 41 , 42 and surgical cleaning 17 , 21 , 23 , 25 , 28 , 30 , 31 , 32 , 33 , 35 , 37 , 40 , 41 were most routinely used among the studies. Moreover, debridement, 16 ,…”

Section: Resultsmentioning

confidence: 99%

“…Moreover, debridement, 16 , 17 , 23 , 24 , 30 , 33 , 34 , 37 , 38 , 41 fasciotomy, 19 , 25 , 32 , 34 , 40 , 42 surgical excision/escharectomy, plastic surgical review, 16 , 19 , 21 , 23 , 28 , 31 and skin graft 20 , 22 , 23 , 24 , 40 were also utilized. There were seven traditional/surgical debridements, 16 , 23 , 24 , 30 , 34 , 37 , 41 three enzymatic debridements, 37 , 38 , 41 three autolytic debridements, 17 , 37 , 41 two mechanical debridements, 37 , 38 and one Versajet™ hydrosurgery system debridement. 33 …”

Section: Resultsmentioning

confidence: 99%

“…The use of dressings as an intervention, as shown in Figure 2d , was evident within 21 studies. 16 , 17 , 19 , 22 , 23 , 24 , 25 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 36 , 37 , 38 , 40 , 41 , 42 Moist gauze (saline/iodine) was the most used dressing, followed by foam, silicone‐based, silver, and hydrocolloid dressings. Dressings used throughout the studies were primarily used after the extravasation injury had been managed with alternative interventions.…”

Section: Resultsmentioning

confidence: 99%

“…16,17,[19][20][21][22][23][24][25]27,28,[30][31][32][33][34][35][36][37][38][40][41][42] Surgical puncture 17,[21][22][23]25,28,30,31,33,35,37,[40][41][42] and surgical cleaning 17,21,23,25,28,[30][31][32][33]35,37,40,41 were most routinely used among the studies. Moreover, debridement, 16,17,…”

Section: Surgicalmentioning

confidence: 99%

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Extravasation injury management for neonates and children: A systematic review and aggregated case series

Dufficy

Takashima

Cunninghame

et al. 2022

Journal of Hospital Medicine

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Background: Pediatric extravasation injuries are significant healthcare-associated injuries, with sometimes significant sequelae. Evidence-based guidance on management is necessary to prevent permanent injury.Purpose: A systematic review of the literature, including aggregated case series, investigating extravasation injury management of hospitalized pediatric patients. Data Sources: PubMed, Cummulative Index to Nursing and Allied Health Literature (CINAHL), and Excerpta Medica database (EMBASE) were searched on December 13, 2021. Study Selection: Primary research investigating extravasation injury management of hospitalized pediatric patients (to 18 years), published from 2010 onwards and in English, independently screened by two authors, with arbitration from a third author. Data Extraction: Data regarding the study, patient (age, primary diagnosis), extravasation (site, presentation, outcome), and treatment (first aid, wound management) were extracted by two authors, with arbitration from a third author.Data Synthesis: From an initial 1769 articles, 27 studies were included with extractable case data reported in 18 studies, resulting in 33 cases. No clinical trials were identified, instead, studies were primarily case studies (52%) of neonates (67%), with varied extravasation symptoms. Studies had good selection and ascertainment, but few met the causality and reporting requirements for quality assessments. Signs and symptoms varied, with scarring (45%) and necrosis (30%) commonly described.Diverse treatments were categorized into first aid, medical, surgical, and dressings.Conclusions: Despite infiltration and extravasation injuries being common within pediatric healthcare, management interventions are under-researched, with low-quality studies and no consensus on treatments or outcomes.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Surgicalmentioning

confidence: 99%

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Extravasation injury management for neonates and children: A systematic review and aggregated case series

Dufficy

Takashima

Cunninghame

et al. 2022

Journal of Hospital Medicine

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Treatment of extravasation injuries in infants and young children: a scoping review and survey

Corbett

Marshall

Harden

et al. 2018

Health Technol Assess

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BackgroundExtravasation injuries are caused by unintended leakages of fluids or medicines from intravenous lines, but there is no consensus on the best treatment approaches.ObjectivesTo identify which treatments may be best for treating extravasation injuries in infants and young children.DesignScoping review and survey of practice.PopulationChildren aged < 18 years with extravasation injuries and NHS staff who treat children with extravasation injuries.InterventionsAny treatment for extravasation injury.Main outcome measuresWound healing time, infection, pain, scarring, functional impairment, requirement for surgery.Data sourcesTwelve database searches were carried out in February 2017 without date restrictions, including MEDLINE, CINAHL (Cumulative Index to Nursing and Allied Health Literature) Plus and EMBASE (Excerpta Medica dataBASE).MethodsScoping review – studies were screened in duplicate. Data were extracted by one researcher and checked by another. Studies were grouped by design, and then by intervention, with details summarised narratively and in tables. The survey questionnaire was distributed to NHS staff at neonatal units, paediatric intensive care units and principal oncology/haematology units. Summary results were presented narratively and in tables and figures.ResultsThe evidence identified in the scoping review mostly comprised small, retrospective, uncontrolled group studies or case reports. The studies covered a wide range of interventions including conservative management approaches, saline flush-out techniques (with or without prior hyaluronidase), hyaluronidase (without flush-out), artificial skin treatments, debridement and plastic surgery. Few studies graded injury severity and the results sections and outcomes reported in most studies were limited. There was heterogeneity across study populations in age, types of infusate, injury severity, location of injury and the time gaps between injury identification and subsequent treatment. Some of the better evidence related to studies of flush-out techniques. The NHS survey yielded 63 responses from hospital units across the UK. Results indicated that, although most units had a written protocol or guideline for treating extravasation injuries, only one-third of documents included a staging system for grading injury severity. In neonatal units, parenteral nutrition caused most extravasation injuries. In principal oncology/haematology units, most injuries were due to vesicant chemotherapies. The most frequently used interventions were elevation of the affected area and analgesics. Warm or cold compresses were rarely used. Saline flush-out treatments, either with or without hyaluronidase, were regularly used in about half of all neonatal units. Most responders thought a randomised controlled trial might be a viable future research design, though opinions varied greatly by setting.LimitationsPaucity of good-quality studies.ConclusionsThere is uncertainty about which treatments are most promising, particularly with respect to treating earlier-stage injuries. Saline flush-out techniques and conservative management approaches are commonly used and may be suitable for evaluation in trials.Future workConventional randomised trials may be difficult to perform, although a randomised registry trial may be an appropriate alternative.FundingThe National Institute for Health Research Health Technology Assessment programme.

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Erythromycin extravasation mimicking necrotising fasciitis in the infant

Cited by 2 publications

References 2 publications

Extravasation injury management for neonates and children: A systematic review and aggregated case series

Extravasation injury management for neonates and children: A systematic review and aggregated case series

Treatment of extravasation injuries in infants and young children: a scoping review and survey

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