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Abstract
The leakage of cytotoxic drugs, intravenous nutrition, solutions of calcium, potassium, bicarbonate and even 10% dextrose outside the vein into which they are delivered is known not only to cause skin necrosis but also to precipitate significant scarring around tendons, nerves and joints.
In this review of 96 patients with extravasation injuries seen between 1987 and 1992 at St Thomas' Hospital, Mount Vernon Hospital and The Hospital for Sick Children, Great Ormond Street, several patients required extensive reconstruction and in some, despite this, extravasation injury has rendered a limb virtually useless.
Two techniques, liposuction and saline flushout, are described to remove extravasated material while conserving the overlying skin. Analysis of flushout material confirmed that the extravasated material was actually being removed. Forty four of the study group in whom noxious materials were known to have extravasated underwent such early treatment. The results in this group were quite striking—the majority (86%) healed without any soft tissue loss at all. The early referral and treatment of extravasation injuries is, therefore, recommended.
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Article info
Publication history
Accepted:
September 16,
1992
Received:
June 18,
1992
Identification
Copyright
© 1993 The British Association of Plastic Surgeons. Published by Elsevier Inc. All rights reserved.