Chemotherapy Drug Extravasation in Totally Implantable Venous Access Port Systems: How Effective is Early Surgical Lavage?

Abstract

CDEs should be managed in specialized centers. ESL allows for limited tissue contact of the chemotherapy drug whilst using a simple, widely accessible technique. The two main factors that correlate with adverse outcome seem to be the nature of the implicated agent (vesicants) and the extravasated volume (above 50 ml) leading to worse outcomes. Oxaliplatin should be considered as a vesicant.

Negative-pressure wound therapy and early pedicle flap reconstruction of the chest wall after epirubicin extravasation

“…Thus, early injury identification is of great importance for rapid and effective decision making. There is a well-documented dose-dependent relation between the volume and concentration of extravasated anthracycline and the extent of skin ulceration (4). In this case, the extravasation went unrecognized, and the patient presented 10 days later with already irreversible tissue damage.…”

Nocebo effects in practice: methotrexate myths and misconceptions

“…The guidelines do not refer to the specific context of low dose administration in non‐neoplastic diseases. Methotrexate is neither a vesicant nor an irritant 18 , 19 and is not an extravasation risk 20 …”

Plastic Surgery in the Multimodal Treatment Concept of Soft Tissue Sarcoma: Influence of Radiation, Chemotherapy, and Isolated Limb Perfusion on Plastic Surgery Techniques

“…The extent of local tissue injury depends on the chemical structure of the applied substance, which is classified as vesicant, irritant, and non-irritant. According to current references, treatment of chemotherapy drug extravasation should be managed in specialized centers ( 26 ). Surgical interventions are indicated in cases of extensive necrotic areas or failure of conservative measures.…”