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 agentsRelated posts:
Stay updated, free articles. Join our Telegram channel
Full access? Get Clinical Tree
