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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