Prevention and conduct against the Extravasation of antineoplastic chemotherapy: a scoping review

Melo, João Marcos Alves; Oliveira, Patrícia Peres de; Souza, Raissa Silva; Fonseca, Deborah Franscielle da; Gontijo, Thaís Fonseca; Rodrigues, Andrea Bezerra

doi:10.1590/0034-7167-2019-0008

Cited by 13 publications

(21 citation statements)

References 25 publications

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“…This study was not submitted to ethical review because it is a review that uses public domain data; these data had their ethical aspects ensured in their original studies (7) .…”

Section: Ethical Aspectsmentioning

confidence: 99%

Assessment of patient safety culture in Brazilian hospitals through HSOPSC: a scoping review

2021

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Objectives: to describe, from literature, the characteristics of patient safety culture in Brazilian hospitals that applied the Hospital Survey on Patient Safety Culture. Methods: this is a scoping review. A search was performed in the databases LILACS, PubMed, SciELO, CINAHL, Web of Science, Scopus and in the CAPES Dissertations and Theses Database in September and October 2020. Results: thirty-six studies were identified. Nine studies identified strengthened areas such as: “teamwork within the units”, “expectations of supervisor/boss and actions promoting safety”, “organizational learning”, “support of hospital management for patient safety” and “frequency of report of events”. As a critical area, the dimension “non-punitive response to error” was evidenced in 30 of 36 studies. Conclusions: the identification of areas of strength and critical areas of safety culture is relevant to encourage improvement of patient safety problems in an institution.

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“…This study was not submitted to ethical review because it is a review that uses public domain data; these data had their ethical aspects ensured in their original studies (7) .…”

Section: Ethical Aspectsmentioning

confidence: 99%

Assessment of patient safety culture in Brazilian hospitals through HSOPSC: a scoping review

2021

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“…As it is also considered as an emergency in Oncology, it requires a duly qualified and trained Nursing team for immediate treatment of this event. In view of this, it is necessary to investigate actions towards the prevention of complications referring to extravasation 1 - 2 .…”

Section: Introductionmentioning

confidence: 99%

“…The mechanism of action is binding of the drug to the iron molecule preventing the formation of free radicals 4 . In addition to being unfeasible for the public sector (due to its price), it can cause side effects such as nausea, vomiting, mild pain at the infusion site and reversible increases in liver enzymes 2 , 5 .…”

Section: Introductionmentioning

confidence: 99%

Effects of photobiomodulation (660 nm laser) on anthracycline extravasation: An experimental study

Freitas

Minicucci

Silva

et al. 2022

Rev. Latino-Am. Enfermagem

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Objective: to investigate the effect of using different agents (topical hyaluronidase, photobiomodulation, and the association of photobiomodulation with topical hyaluronidase) in preventing the formation of lesions caused by doxorubicin extravasation, as well as in the reduction of lesions formed by extravasation of this drug. Method: a quasi-experimental study conducted with 60 Wistar rats, randomized into four groups with 15 animals each. Group 1 (Control); Group 2 (Hyaluronidase); Group 3 (Photobiomodulation); and Group 4 (Hyaluronidase + Photobiomodulation). A wound was induced by applying 1 mg of doxorubicin to the subcutaneous tissue of the back of the animals. The concentration of topical hyaluronidase was 65 turbidity units/g and the energy employed was 1 joule of 100 mW red laser per square centimeter. With macroscopic evaluation every two days for 28 days, the following variables were observed: skin integrity, presence of blisters, hyperemia, exudate, bleeding, edema, crust, peeling and granulation tissue. Results: the animals from the groups subjected to photobiomodulation obtained better results in the assessment of the following variables: bleeding, hyperemia, exudate, intact skin and edema. Conclusion: it was evidenced that the association of photobiomodulation with topical hyaluronidase was effective in reducing the local effects and assisted in the wound healing process, and that PBM alone was able to prevent appearance of lesions.

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“…Although anthracyclines are potent vesicants, it is not known if there is a subcutaneous tissue dose-response relation with a threshold level to initiate irreversible cellular damage resulting in tissue necrosis [2]. Despite efforts to refine and to detail management guidelines by cancer organizations [3], educational efforts [4] and deep literature search with emphasis on clinical evidence for prevention and management in cancer nursing [5], this topic was not addressed so far due to its experimental character. Moreover, little is known about the distribution within the affected lesion and the tissue clearance to reduce the toxic pressure and enable wound healing [6].…”

Section: Introductionmentioning

confidence: 99%

Tissue distribution of epirubicin after severe extravasation in humans

Nedomansky

Haslik

Pluschnig

et al. 2021

Cancer Chemother Pharmacol

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Purpose As critical parameter after extravasation of cytotoxic vesicants, anthracyclines were determined in removed tissue from patients requiring surgical intervention due to tissue necrosis. We monitored their distribution within the affected lesion to establish a possible dose–toxicity relation. Methods From six patients scheduled for surgery, removed tissue flaps were systematically analysed by HPLC (epirubicin: 5 subjects; doxorubicin: 1 subject). Results After extravasation, tissue concentrations were highly variable with an individual anthracycline distribution pattern ranging from a few nanograms up to 17 µg per 100 mg tissue, which indicated a substantial difference in tissue sensitivity among patients. The resection borders coincided with the extension of the erythema and guided the surgical intervention after demarcation of the lesion, which occurred usually 2 or 3 weeks after extravasation. At that time, drug was hardly detected at the resection borders. Wound drains were negative for the extravasated drugs while showing a time profile of vascular growth factors and inflammatory cytokines, which was highly similar to routine surgery. In all six patients, surgical debridement with immediate wound closure led to healing within approximately 2 weeks, when therapy was resumed in all patients with reasonable time delay. Conclusion Surgical intervention after demarcation of the extravasation lesion allows for almost uninterrupted continuation of treatment independent of the amount of extravasated anthracycline. As even minor amounts of the vesicants may trigger tissue necrosis, preventive measures merit the highest priority.

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Prevention and conduct against the Extravasation of antineoplastic chemotherapy: a scoping review

Cited by 13 publications

References 25 publications

Assessment of patient safety culture in Brazilian hospitals through HSOPSC: a scoping review

Assessment of patient safety culture in Brazilian hospitals through HSOPSC: a scoping review

Effects of photobiomodulation (660 nm laser) on anthracycline extravasation: An experimental study

Tissue distribution of epirubicin after severe extravasation in humans

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