Skin Necrosis From Extravasation of Intravenous Fluids in Children

Brown, Arthur S.; Hoelzer, Dennis J.; Piercy, Sharon A.

doi:10.1097/00006534-197908000-00002

Cited by 104 publications

(52 citation statements)

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“…Conservative measures such as elevation of the affected limb or the application of heat or cold have not shown any benefit [7,[11][12][13][14]. It has also been recommended that the cannula is left in-situ as it may be used as a route to either administer an antidote or to aspirate the extravasated drug [7,11].…”

Section: Discussionmentioning

confidence: 99%

Extravasation of Parenteral Nutrition in the Neck: A Case Report

Davidoss¹,

Ha²

2017

Gen Int Med Clin Innov

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Section: Discussionmentioning

confidence: 99%

Extravasation of Parenteral Nutrition in the Neck: A Case Report

Davidoss¹,

Ha²

2017

Gen Int Med Clin Innov

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“…Of the 26 group studies included in the scoping review, 4,21,31-54 only two were comparative. 16,55 Records identified through database searching …”

Section: Quantity and Quality Of Research Availablementioning

confidence: 99%

“…16,55 Full details of the studies are presented in Table 1. In 1979, Brown et al 55 published results for a quasi-randomised study which compared three types of treatment: silver sulfadiazine cream with sterile saline cleansing, povidone-iodine with sterile saline cleansing and sterile saline cleansing alone. The 34 study participants had extravasation injuries resulting in skin loss, and were mostly aged < 1 year.…”

Section: Comparative Studiesmentioning

confidence: 99%

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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“…The resulting injury depends on the substance that extravasates, and can range from mild skin irritation to severe necrosis (Boyle and Engelking, 1995). Patients with small and fragile veins, such as the very young or very old, are at a greater risk of extravasation injuries (Brown et al, 1979). Patients receiving chemotherapy are likely to develop more severe reactions due to the cytotoxic drugs involved (Langer, 2010).…”

Section: Extravasation Injuriesmentioning

confidence: 99%

Textbook of Plastic and Reconstructive Surgery

Butler¹,

Ghali²,

Kalaskar³

2016

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A CIP catalogue record for this book is available from The British Library.This book is published under a Creative Commons Attribution Non-commercial Non-derivative 4.0 International license (CC BY-NC-ND 4.0). This license allows you to share, copy, distribute and transmit the work for personal and non-commercial use providing author and publisher attribution is clearly stated. Further details about CC BY licenses are available at http://creativecommons.org/ licenses/by/4.0The publishers cannot guarantee the accuracy of any information about dosage and application contained in this book. The user is advised to always check the product information and clinical procedures with the most up-to-date published product information and the most recent codes of conduct and safety regulations. The authors and the publishers do not accept responsibility or legal liability for any errors in the text or misuse or misapplication of material in this work.ISBN: 978-1-910634-37-0 (Hbk.) ISBN: 978-1-910634-38-7 (Pbk.) ISBN: 978-1-910634-39-4 (PDF) ISBN: 978-1-910634-40-0 (epub) ISBN: 978-1-910634-41-7 (mobi)

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Skin Necrosis From Extravasation of Intravenous Fluids in Children

Cited by 104 publications

References 0 publications

Extravasation of Parenteral Nutrition in the Neck: A Case Report

Extravasation of Parenteral Nutrition in the Neck: A Case Report

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

Textbook of Plastic and Reconstructive Surgery

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