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Management of extravasation injuries in upper extremity

Hasan Gocer, Serdar Ulusoy, Alper Cirakli, Sina Coskun, Engin Yosma.


Abstract

Introduction: When contrast agents and chemotherapeutic agents used for diagnosis and treatment through vascular access are extravasated, they may cause many complications, ranging from tissue necrosis to amputation. In this study, extravasation of certain agents was evaluated.
Material and methods: Five cases that developed from vancomycin, isotonic sodium, contrast agent and teicoplanin extravasation were examined.
Results: Three of the patients were female and two were male. Their mean age was 42.8 years. One of them had complications seen in the right and four had complications observed in the left upper extremity. One of these cases underwent wrist amputation, three had fasciotomy and repair, and one had fasciotomy, recurrent debridement and reconstruction with a split-thickness skin graft.
Conclusion: When extravasation is seen, the agent should stop being administered and the case should be monitored closely. In the situation of an increase in swelling and stiffness and absence of motion in the muscles and tendons, compartment syndrome should be considered and urgent fasciotomy should be performed. Early fasciotomy can be a savior while in where there is development of necrosis during late periods, amputation may be necessary.

Key words: Extravasation, fasciotomy, amputation






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