Extravasation Injuries

Extravasation Injuries

Martin I. Boyer

  • Definition: The infiltration into the subcutaneous and/or deep tissues by fluids administered usually through an intravenous cannula. It is most frequently associated with chemotherapeutic agents, phenytoin, or intravenous contrast dye.

  • Pathogenesis

    • Direct cytotoxicity

    • Osmolar rupture

    • Vasopression, or cationic cellular toxicity

    • Mechanical compression

    • Secondary bacterial infection

  • Early treatment

    • Controversial

    • Expectant (ice and elevation)

    • Local injection of hyaluronidase 1,500 IU followed by flush with NS through multiple small incisions over the affected area

    • Topical free radical scavengers (dimethylsulfoxide plus topoisomerase-2 inhibitor desrazoxane IV)

    • Topical corticosteroids

    • Goal of treatment is to mitigate against skin loss directly over gliding tissue by local elimination (as much as possible) of the cytotoxic agent

  • Specific agents

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May 23, 2016 | Posted by in Hand surgery | Comments Off on Extravasation Injuries
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