Adriamycin Extravasation: Surgical Treatment and Possible Prevention of Skin and Soft-Tissue Injuries

Pitkänen, Jaakko; Asko‐Seljavaara, Sirpa; Gröhn, Pentti; Sundell, B; Heinoen, E.; Appelqvist, P

doi:10.1016/s0022-5347(17)50421-8

Cited by 5 publications

(11 citation statements)

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“…This is the first and often only step needed for extravasation injury management and it includes: (Kumar et al, 2009;Langstein et al, 2002;Larson, 1982;Pitkänen et al, 1983;Shenaq et al, 1996): a) Pain relief. b) Application of ice: Commonly 15 min sessions four times daily for 3 days to decrease the spread of drugs into adjacent tissues (via vasoconstriction), slow down the cellular metabolic rate, and deactivate the extravasated agent.…”

Section: A) Conservative Managementmentioning

confidence: 99%

Extravasation injuries: a review

Goutos

Cogswell

Giele

2014

J Hand Surg Eur Vol

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Extravasation injuries are common emergencies in clinical practice. If they are not recognized and treated promptly, they can lead to deleterious functional and cosmetic outcomes. There is a vast range of agents involved in these injuries and marked paucity of evidence to support their specific management. Following an extensive literature review, we outline management principles for clinicians involved in the care of patients with extravasation injuries. Key parameters in deciding appropriate management plans include the volume/toxicity of the agent, the necrosis interval of the injury, patient-related factors, as well as the facilities and expertise available in the setting of individual cases of extravasation.

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Section: A) Conservative Managementmentioning

confidence: 99%

Extravasation injuries: a review

Goutos

Cogswell

Giele

2014

J Hand Surg Eur Vol

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“…1, 2). After a median 18 month follow-up (range [16][17][18][19][20], all patients had recovered satisfactorily.…”

Section: Patients Methods and Resultsmentioning

confidence: 99%

“…Some authors consider the use of grafts as the gold standard. We used grafts in only one case with superficial necrosis (12,15,20,21). In other cases we have used different flaps, making the choice after careful evaluation of the extension, site, and the state of the lesion.…”

Section: Discussionmentioning

confidence: 99%

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Surgical treatment of ulcers caused by extravasation of cytotoxic drugs

D’Andrea

Onesti

Nicoletti

et al. 2004

Scandinavian Journal of Plastic and Reconstructive Surgery and

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Despite preventive measures, the extravasation of cytotoxic drugs still occurs in 0.6% to 6% of cases. The aetiology is thought to be that tissue necrosis develops into a chronic ulcer, which causes problems if the harmful action of the drug is not blocked. From 1988-2002 at the Department of Plastic Surgery of Rome University "La Sapienza", 240 patients presented with extravasation of cytotoxic drugs; all had been treated with an original conservative protocol first described in 1994, based on the repeated local infiltration of a large quantity of saline solution (90-540 ml) into the area of extravasation. We considered only cases with actively necrotic lesions. Eleven of the 240 patients (5%) had ulcers ranging from small ulcers to extensive areas of tissue necrosis. Of the 11 patients, eight had already had ulcers, while the remaining three were those in whom our conservative protocol had not prevented necrosis. They were all operated on and given grafts, local flaps, reverse radial flaps, and free flaps.

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“…For long, it was generally agreed that for significant extravasation drugs such as the anthracyclines and mitomycin C, surgery should be performed to remove the tissue-bound drug [5,[10][11][12][13][14][15]. Often, only the timing of the intervention has been open for discussion (ie, early vs late surgery).…”

Section: General Considerations In Chemotherapy Extravasationmentioning

confidence: 99%

Extravasation of Chemotherapy

Langer

2010

Curr Oncol Rep

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Extravasation of chemotherapy is a feared complication of anticancer therapy. The accidental leakage of cytostatic agents into the perivascular tissues may have devastating short-term and long-term consequences for patients. In recent years, the increased focus on chemotherapy extravasation has led to the development of international guidelines that have proven useful tools in daily clinical practice. Moreover, the tissue destruction in one of the most dreaded types of extravasation (ie, anthracycline extravasation) now can effectively be prevented with a specific antidote, dexrazoxane.

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Adriamycin Extravasation: Surgical Treatment and Possible Prevention of Skin and Soft-Tissue Injuries

Cited by 5 publications

References 0 publications

Extravasation injuries: a review

Extravasation injuries: a review

Surgical treatment of ulcers caused by extravasation of cytotoxic drugs

Extravasation of Chemotherapy

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