Surgical management of a hand extravasation of anthracycline at late presentation (original) (raw)

Anthracycline extravasation injuries: management with dexrazoxane

Therapeutics and Clinical Risk Management, 2009

The application of anthracyclines in anticancer therapy may result in accidental extravasation injury and can be a serious complication of their use. Tissue necrosis with skin ulceration is a possible outcome in the inadvertent extravasation of anthracyclines during intravenous administration. Until recently, there has been no effective treatment against the devastating effect of extravasated anthracycline. Preclinical and clinical studies are leading to the clinical implementation of dexrazoxane as the first and only proven antidote in anthracycline extravasation. In two multicenter studies dexrazoxane has proven to be highly effective in preventing skin necrosis and ulceration. This review focuses on the development and management of dexrazoxane in anthracycline extravasation injuries.

Extended Arm Necrosis by Chemotherapy Drugs Extravasation

Complications of chemotherapy stem from the toxicity of products used and complications related to the modes and routes of administration of these products. To minimize the risks associated with the latter, due to the toxicity of the drugs administered and the long duration of treatment requiring repeated access to the venous system, the use of implantable venous access port is recommended for the administration of these products. However, this does not exclude the risk of complication occurrence such as extravasation of cytotoxic drugs. Passage in extravascular areas of chemotherapy drugs is a relatively less frequent incident but may lead to injury up to the extensive tissue necrosis that can worsen the patient's prognosis and alter his functional life comfort. Although this complication is very well known and widely described in literature, very few cases have been reported hence the interest of this case report.

Overview, prevention and management of chemotherapy extravasation

World journal of clinical oncology, 2016

Chemotherapy extravasation remains an accidental complication of chemotherapy administration and may result in serious damage to patients. We review in this article the clinical aspects of chemotherapy extravasation and latest advances in definitions, classification, prevention, management and guidelines. We review the grading of extravasation and tissue damage according to various chemotherapeutic drugs and present an update on treatment and new antidotes including dexrazoxane for anthracyclines extravasation. We highlight the importance of education and training of the oncology team for prevention and prompt pharmacological and non-pharmacological management and stress the availability of new antidotes like dexrazoxane wherever anthracyclines are being infused.

Extravasation of Chemotherapeutic Agents: Prevention and Treatment

Seminars in Oncology, 2006

Most chemotherapeutic agents can cause varying degrees of local tissue injuries when extravasated. The medical treatment of extravasation is based on proper maintenance of the intravenous (IV) line and application of cold or warm compresses, plus the use of antidotes when available. Antidotes for extravasation that have been shown to be useful are sodium thiosulfate for nitrogen mustard, dimethylsulfoxide for anthracyclines and mitomycin, and hyaluronidase for the vinca alkaloids. New treatments include dexrazoxane, sargramostim, and hyperbaric oxygen for doxorubicin extravasations. Tissue damage secondary to drug infiltration occurs as a result of one of two major mechanisms: (1) the drug is absorbed by local cells in the tissue and binds to critical structures (eg, DNA, microtubules), causing cell death; and (2) the drug does not bind to cellular DNA. Damage to immediately adjacent tissue is more readily neutralized than is damage to surrounding tissue.

Evaluation of Post-operative wound complications in patients getting neoadjuvant chemotherapy

2021

Aim: To analyse the post-operative wound complications in patients getting neoadjuvant chemotherapy in respect to those patients who underwent surgery without any neoadjuvant chemotherapy. Material and method: The present prospective observational study was conducted in GMCH AMRITSAR Punjab.It consisted of 50 female patients admitted with breast carcinomadivided into group of 25 each, one group that received neoadjuvant chemotherapy and the other group which underwent surgery first. Results: The mean age of the patients was 50.16±11.57 years. no significant difference was observed in age, wound complications, healing time between the two groups. Flap necrosis was seen in 4% cases and 12% cases in group 1(primary surgery) and 2(NACT) respectively. Seroma was seen in 16% and 8% cases in group 1 and 2 respectively. 12% cases of group 1 and 20% cases of group 2 presented with wound infection. Patients with DM presented with more complication in both the groups. The difference between bo...

Post mastectomy wound complications with or without neoadjuvant chemotherapy

2021

Aim: To analyse the post-operative wound complications in patients getting neoadjuvant chemotherapy in respect to those patients who underwent surgery without any neoadjuvant chemotherapy. Material and method: The present prospective observational study was conducted in GMCH AMRITSAR Punjab.It consisted of 50 female patients admitted with breast carcinomadivided into group of 25 each, one group that received neoadjuvant chemotherapy and the other group which underwent surgery first. Results: The mean age of the patients was 50.16±11.57 years. no significant difference was observed in age, wound complications, healing time between the two groups. Flap necrosis was seen in 4% cases and 12% cases in group 1(primary surgery) and 2(NACT) respectively. Seroma was seen in 16% and 8% cases in group 1 and 2 respectively. 12% cases of group 1 and 20% cases of group 2 presented with wound infection. Patients with DM presented with more complication in both the groups. The difference between bo...