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Although Compartment Syndrome is a common surgical emergency with a plethora of aetiologies, Intravenous extravasation of Computed Tomography (CT) contrast medium causing acute compartment syndrome has been reported very rarely. We present a 61-year-old female who underwent abdominal CT with Intravenous contrast for irreducible, recurrent incisional hernia, presented with persistent excruciating pain and progressive multiple blister formation over the left forearm and hand following intravenous contrast material injection via the left dorsum of the hand. Clinical diagnosis of compartment syndrome was made, X-ray left forearm and hand confirmed soft tissue contrast extravasation. She was taken for emergency decompression fasciotomy of the left forearm and hand compartments, and later partial wound closure and split skin graft into remaining areas were carried out. Clinicians and radiologist should aware of this potential complication for its early recognition, management and prevention.
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Objective To explore the treatment effect of potato homogenate on the treatment of drug extravasation during intravenous injection.Methods 320 cases of drug extravasation patients during the intravenous infusion were randomly divided into the potato homogenategroup,named group A; patato slice group named group B and magnesium sulfate group as group C.The group A,B and C were separately treated with the external application of potato homogenate,thin slice of fresh potato and 33％ magnesium sulfate.The therapeutic effects of the 3 groups were compared.Results The therapeutic effect of group A was superior to that of group B and C,and the healing time in group A was much shorter than that in group B and C,and group B was batter than group C,there was significant difference between the above comparison groups.Conclusions The therapeutic effect of external application of fresh potato in the treatment of extravasation injury caused by the drugs is remarkable.Potato homogenate can improve the treatment effect and shorten healing time when compared with potato slice.
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Objective To establish animal models in order to provide an experimental study basis for both the pathogenesis study and taking effective prevention scheme for doxorubicin extravasation injury. Methods A total of 20 Kunming mice for experiments on doxorubicin extravasation injury were divided in-to four groups, I.e., high dose group(2 g/L), medium dose group(1 g/L), low dose group(0.5 g/L) and the control group (injection with water). Dosages were administered with subcutaneous injection on both sides of mice abdomen. The adverse reaction of body, damage areas of extravasation injury, recovery period were observed and histopathologic slides of animal models on both 4 days and 11 days after experiment were performed and compared. Results No significant adverse body reaction was observed after injection for all groups. The damage areas due to extravasation injury were dosage and concentration dependent. In addi-tion, significant differences in recovery period were observed for mice in different groups, that is, the higher injection concentration and dose led to the longer recovery period. Results from the histopathologic study in-dicated that the putrescence of damage area was developed in high dose group mice, and the ulcer occurred after 4 d of dosage in medium dose group mice, respectively. In contrast, no ulcer was observed in low dose group mice. Conclusions It would be feasible to establish a prevention model for mice on doxorubicin extravasation injury by subcutaneous injection at a dosage of 0.05ml(1 g/L).
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PURPOSE: Local skin necrosis after extravasation of adriamycin, a widely used chemotherapeutic agent, is a common problem in cancer patients. The extravasation of chemotherapeutic agents yields severe inflammatory responses, crust formation, skin necrosis, and ulceration. Even though several treatment options have been proposed for extravasation injury, there is still controversy regarding the management of such lesions. Thus the aim of this study was to compare the efficacy of saline injection (Group 1), hydrocortisone injection (Group 2), propranolol injection (Group 3) and early surgical excision as a treatment (Group 4) in a rat extravasation model. METHODS: The authors planned forty mature male Sprague-Dawley rats were divided into 4 groups and each group contained 10 rats. Administration of adriamycin (1.0 mg/mL) 1.5 mL by subcutaneous injection on the dorsal side of the rats was followed by protocol. The treatment options were applied 2 hours after adriamycin injection. At the end of the 5th day, the presence and size of ulcers at the injection site were checked. Three weeks after injection, a histopathologic examination was performed for each treatment and control group. T-tests were used to analyze the differences between the measurements. RESULTS: Propranolol significantly improved tissue recovery compared with control group and other groups. These data suggest that there is little role for saline and hydrocortisone in the treatment of adriamycin extravasation injury. CONCLUSION: In this study, we compared some treatment methods in adriamycin extravasation model. The findings support the propranolol injection may prevent extravasation injury. However this study was performed in the laboratory using rats, and the results could be different in clinical application. Further investigations and more clinical application are needed.
Subject(s)
Animals , Humans , Male , Rats , Doxorubicin , Hydrocortisone , Injections, Subcutaneous , Necrosis , Propranolol , Rats, Sprague-Dawley , Skin , UlcerABSTRACT
Objective To find an effective method for the treatment of mitomycin C extravasation injuries. Methods The rabbit model of mitomycin C extravasation was made and managed by different methods. The therapeutic efficacy in each group was assessed by using regression index and regression time. Results The therapeutic efficacy in ice compress group and ice compress plus amifostine group was better than that in other groups and the regression time was the shortest. There was no inflammation and necrosis in skin in ice compress group. Conclusion Ice compress, which can prevent inflammation and necrosis in skin, is one of the most effective treatment methods for mitomycin C extravasation injuries.
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Extravasation of toxic chemotherapeutic 'agents cause severe skin ulceration and necrosis which often need secondary surgical intervention. Still, there were not established antidote agent in case of extravasation with mitomycin-c. Dimethyl sulfoxide is known as an effective chemical scavenger of toxic hydroxyl free radical and sodium thiosulfate also was demonstrated significant protector from mitomycin-c induced ulceration by a few experimental studies. Author investigated necrotic area of mitomycin-c injected site and compare to the effectiveness of topical treatment with dimethyl sulfoxide and intradermal injection of sodium thiosulfate according to starting times, forty five mice were divided into 3 groups. Control group(n=5) had no treatment after subcutaneous injection of mitomycin-c. Experimental group I and 11 were 20 mice treated dimethyl sulfoxide and sodium.