Extravasation injuries

Abstract

The leakage of cytotoxic drugs, intravenous nutrition, solutions of calcium, potassium, bicarbonate and even 10% dextrose outside the vein into which they are delivered is known not only to cause skin necrosis but also to precipitate significant scarring around tendons, nerves and joints. In this review of 96 patients with extravasation injuries seen between 1987 and 1992 at St Thomas' Hospital, Mount Vernon Hospital and The Hospital for Sick Children, Great Ormond Street, several patients required extensive reconstruction and in some, despite this, extravasation injury has rendered a limb virtually useless. Two techniques, liposuction and saline flushout, are described to remove extravasated material while conserving the overlying skin. Analysis of flushout material confirmed that the extravasated material was actually being removed. Forty four of the study group in whom noxious materials were known to have extravasated underwent such early treatment. The results in this group were quite striking--the majority (86%) healed without any soft tissue loss at all. The early referral and treatment of extravasation injuries is, therefore, recommended.

Extravasation of Parenteral Nutrition in the Neck: A Case Report

“…A variation of this technique combining saline lavage with suction has been which was performed on a patient with doxorubicin extravasation injury [17]. The saline flush-out technique described by Gault was used in the neonatal intensive care setting to treat two newborns with TPN extravasation [6,8]. Both infants healed with minimal scarring and no functional defect [6].…”

“…However, there are only a few case reports of this occurring in adults with the vast majority of reports over a decade old [3,[6][7][8][9][10] (Table 1). TPN is a complex mixture of a wide variety of substances including amino acids, dextrose, lipids, vitamins, electrolytes and trace elements [4].…”

Hyperbaric Oxygen Therapy In Calcium Chloride Extravasation Injuries: An Experimental Animal Study

“…Yilmaz et al described a successful saline flushout method in their experimental study in rats (10). In this technique a blunt-ended canula with side holes is used to inject saline (11). Chandavashu et al performed multiple punctures by using a sterile blood drawing stylet to make perforations over the area of swelling (12).…”

Ekstravaseringsskader

“…Subkutan skylling foregår ved å legge noen små incisjoner i det affiserte området slik at hele området kan skylles for å redusere konsentrasjonen av ekstravasert substans (14). Faren med denne metoden er at man injiserer skyllevann som ikke kommer ut igjen -på den måten kan skaden bli større ved økt ødemdanning og økt hydrostatisk trykk.…”