Sofortige offene chirurgische Behandlung von Zytostatika-Paravasaten der oberen Extremität

Abstract

Extravasations of cytostatic agents can create necrosis of soft tissues in the hand and forearm. The early emergency subcutaneous "wash-out" with liposuction is the treatment of choice to avoid the development of soft-tissue defects. The objective of this study was to evaluate the open surgical debridement as a possible alternative method since the liposuction device is not commonly available in every hospital. In our study 10 patients were treated for extravasations of cytostatic drugs with a high potential for necrosis by emergency open debridement. All patients were evaluated prospectively by photography and clinical examination. 9 patients out of ten had a primary wound healing, one displayed a wound dehiscence with pre-existing MRSA infection. Another patient developed a seroma postoperatively which was treated by puncture. The mean functional outcome was good. The Eemergency open surgical treatment is a simple, in every hospital suitable therapy to prevent soft-tissue necrosis after extravasation of cytostatic drugs.

Managing chemotherapy extravasation in totally implantable central venous access: Use of subcutaneous wash-out technique

“…For Onesti et al, 11 this subcutaneous lavage can be administrated three times a week in the severer cases, up to six infiltrations every 3 days, but with a low volume (<100 mL) and without stab incisions. Telisselis et al 44 described an opposite technique: a subcutaneous wash-out with preventive open surgical debridement and liposuction. Our technique may be less invasive, simpler to implement and accessible to all surgeons.…”