Management of extravasation injuries

Kumar, Rajiv; Pegg, Shane; Kimble, Roy M.

doi:10.1046/j.1440-1622.2001.02104.x

Cited by 83 publications

(70 citation statements)

References 19 publications

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“…It is better to pierce the vein once when making an intravenous route. Piercing several times making holes and injuries in the vein increases the possibility of extravasation, because drugs can extravasate via the hole in the vessel [10]. Compression between the intravenous injection site and the proximal part should be avoided.…”

Section: Discussionmentioning

confidence: 99%

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A Case of Skin Necrosis after Extravasation of Intravenous Immunoglobulin

Kim¹

2012

Pediatr Therapeut

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Extravasation of certain drugs can make an injury on the injection site. It occurs more often in the fragile skin of children and old people. Immunoglobulin treats immune-mediated diseases effectively, such as a primary deficiency of antibodies or autoimmune diseases. A 9 months old boy came to hospital complaining of a fever for 5 days. He had bilateral non-purulent conjunctival injection, erythema of the lips and rashes on the hands and feet. On the echocardiography, the left coronary artery was dilated. He was diagnosed with Kawasaki disease. We started an intravenous immunoglobulin injection. After 7 hours, edema and a change in skin color appeared at the intravenous injection site on his right hand. We removed the catheter and applied a cold pack. Under impression of phlebitis, we applied Mupirocin ointment and Prednicarbate ointment with a dressing, twice a day. Within an outpatient follow up period, a skin necrosis with pus emerged. Coagulase negative Staphylococcus was detected from the pus by microbial culture study. We referred the patient to the Department of Plastic Surgery, and operated a debridement of the skin necrosis and a full thickness skin graft. He was discharged from hospital without a certain problem. The lesion was cured and left a scar. There was no recurrence or exacerbation on the skin graft lesion within a follow up period of 6 months since the surgery. We report a rare case of skin necrosis after extravasation of intravenous immunoglobulin, which had not been reported in Korea before.

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Section: Discussionmentioning

confidence: 99%

“…Skin side effects reported after using IVIG are reported such as eczema, alopecia, erythema multiforme, lichenoid dermatitis, pompholyx [8,9]. There have been two case reports of the skin necrosis after the intravenous immunoglobulin extravasation in worldwide, one is from Australia and the other is from New Zealand [10,11].…”

Section: Introductionmentioning

confidence: 99%

A Case of Skin Necrosis after Extravasation of Intravenous Immunoglobulin

Kim¹

2012

Pediatr Therapeut

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“…Debridement and skin grafting to the area of skin loss have been reported as a successful surgical method in management of nine patients with extravasation injuries whose age ranged from 17 days to 60 years (9). Warm compresses provide a symptomatic relief by reabsorbing infiltrating solutions due to local vasodilatation.…”

Section: Discussionmentioning

confidence: 99%

“…Calcium chloride is commonly used in parenteral alimentation fluids and may cause local swelling, erythema, blistering and progresses to skin necrosis and skin loss (5). The most important part of extravasation injury is to prevent leakage of infused fluid into surrounding tissue, which may cause damage.…”

Section: Introductionmentioning

confidence: 99%

Hyperbaric Oxygen Therapy In Calcium Chloride Extravasation Injuries: An Experimental Animal Study

et al. 2007

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Aim: Parenteral alimentation fluids containing calcium are widely used to treat sick neonates and children. Extravasation of calcium presents with local swelling, erythema, blistering and progresses to skin necrosis and skin loss. Several treatment modalities including hyperbaric oxygen therapy have been used for extravasation injuries. The role of hyperbaric oxygen therapy on extravasation injuries was investigated in this study by an experimental rat model based on facilitating effect of hyperbaric oxygen on wound healing.Methods: After shaving the dorsal side of 16 female Wistar rats, 1 ml of calcium chloride were injected intradermally. The rats were divided into two groups as control and hyperbaric oxygen. The control group received no treatment while the hyperbaric oxygen group received hyperbaric oxygen therapy for 7 days after injection. At the end of seventh day skin biopsy including all necrotic tissue and surrounding healthy tissue were obtained and histopathologic examination was performed for control and hyperbaric oxygen groups.Results: Hyperbaric oxygen group showed a statistically significant preservation of epidermis and dermis with minimal necrosing findings of skin injury.Conclusion: Although further research is required to develop management guidelines, we concluded that in this experimental study, hyperbaric oxygen therapy prevents dermal injury and may decrease the morbidity associated with calcium chloride extravasation injury.

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“…Extravasation of intravenously infused vesicant solutions is a common problem in medical practice, which can lead to severe and progressive tissue dysfunction, ranging from persistent tissue oedema and fibrosis to delayed tissue necrosis (1,2). Acyclovir is a known vesicant medication administrated in paediatric patients, which appears to irritate venous and soft tissue if extravasated (3,4).…”

Section: Introductionmentioning

confidence: 99%