Extravasation injuries: a review

Abstract

Extravasation injuries are common emergencies in clinical practice. If they are not recognized and treated promptly, they can lead to deleterious functional and cosmetic outcomes. There is a vast range of agents involved in these injuries and marked paucity of evidence to support their specific management. Following an extensive literature review, we outline management principles for clinicians involved in the care of patients with extravasation injuries. Key parameters in deciding appropriate management plans include the volume/toxicity of the agent, the necrosis interval of the injury, patient-related factors, as well as the facilities and expertise available in the setting of individual cases of extravasation.

Extravasation injury in a paediatric population

“…Multiple risk factors have been identified in the aetiology of extravasation injuries . Previous studies have identified that limbs are at increased risk of extravasation injuries with up to 60% occurring in upper limbs . Our study had a similar number (70%).…”

“…Extravasation injuries are common referrals to plastic surgeons in paediatric hospitals with previous studies having quoted rates of 11–70% in children receiving intravenous (IV) medications . Garland et al .…”

Computed tomography contrast media extravasation: treatment algorithm and immediate treatment by squeezing with multiple slit incisions

“…This promotes the removal of extravasated material by the lymphatics and capillaries . It is generally accepted that hyaluronidase is a safe and efficacious treatment used for extravasation of many different agents . Topical application of silver sulfadiazine and Intrasyte gel to the affected area is recommended whenever skin blistering is observed .…”

“…Topical application of silver sulfadiazine and Intrasyte gel to the affected area is recommended whenever skin blistering is observed . More invasive methods of treatment include saline irrigation followed by suction, local administration of various vitamins and enzymes, negative pressure therapies and a combination of liposuction and saline/hyaluronidase washout . Prompt fasciotomy is required if compartment syndrome is suspected.…”

Opções de tratamento cirúrgico em lesões cutâneas por extravasamento acidental de drogas: experiência do Hospital das Clínicas da Faculdade de Medicina da USP.

“…I njury due to extravasation of drugs is the major cause of iatrogenic morbidity in the hospital environment 1 . The incidence of this event in the literature from varies 0.1% to 6% in adult patients and from 11% to 70%, in children 2,3 . Patients at extremes of age, neonates and the elderly, are at greater risk of injury by extravasation, in addition to individuals with altered levels of consciousness or sedated, who are unable to express pain 4 .…”