Abstract
Chemotherapy extravasation is a devastating complication for a patient undergoing breast cancer treatment. It causes extreme pain and suffering for the patient and is a vexing problem for the treating clinician. The goal of treatment is to restore the chemotherapy schedule and prevent any long term complications. This chapter summaries the management of chemotherapy extravasation, it begins with recognising the signs, severity and agents of extravasation and further elaborates pharmacological, non-pharmacological and surgical treatment of the same. In conclusion, the authors provide a flow chart which is easy to follow in order to administer timely and appropriate treatment of this condition.
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References
Maly C, Fan KL, Rogers GF, et al. A primer on the acute Management of Intravenous Extravasation Injuries for the plastic surgeon. Plast Reconstr Surg Glob Open. 2018;6(4):e1743. https://doi.org/10.1097/GOX.0000000000001743.
Larson DL. What is the appropriate management of tissue extravasation by antitumor agents? Plast Reconstr Surg. 1985;75(3):397–405. https://doi.org/10.1097/00006534-198503000-00017.
US. Department of Health and Human Services, National Institute of Health, National Cancer Institute. Common terminology criteria for adverse events (CTAE) 2017.
Al-Benna S, O’Boyle C, Holley J. Extravasation injuries in adults. ISRN Dermatol. 2013;2013:856541. https://doi.org/10.1155/2013/856541.
Kreidieh FY, Moukadem HA, El Saghir NS. Overview, prevention and management of chemotherapy extravasation. World J Clin Oncol. 2016;7(1):87–97. https://doi.org/10.5306/wjco.v7.i1.87.
Allwood M, Stanley A, Wright P, editors. Cytotoxics handbook. 4th ed. Oxford: Radcliffe Medical Press; 2002.
Dychter SS, Gold DA, Carson D, Haller M. Intravenous therapy: a review of complications and economic considerations of peripheral access. J Infus Nurs. 2012;35(2):84–91. https://doi.org/10.1097/NAN.0b013e31824237ce.
Onesti MG, Carella S, Fioramonti P, Scuderi N. Chemotherapy extravasation management: 21-year experience. Ann Plast Surg. 2017;79(5):450–7. https://doi.org/10.1097/SAP.0000000000001248.
Giunta R. Early subcutaneous wash-out in acute extravasations. Ann Oncol. 2004;15(7):1146–7. https://doi.org/10.1093/annonc/mdh271.
Gault DT. Extravasation injuries. Br J Plast Surg. 1993;46:91–6.
Napoli P, Corradino B, Badalamenti G, Tripoli M, Vieni S, Furfaro MF, Cordova A, Moschella F. Surgical treatment of extravasation injuries. J Surg Oncol. 2005;91(4):264–8; discussion 268-9. https://doi.org/10.1002/jso.20248.
Steiert A, Hille U, Burke W, et al. Subcutaneous wash-out procedure (SWOP) for the treatment of chemotherapeutic extravasations. J Plast Reconstr Aesthet Surg. 2011;64(2):240–7. https://doi.org/10.1016/j.bjps.2010.04.040.
Tsai YS, Cheng SM, Ng SP, Yang FS, Shih SL, Sheu CY, Huang JK. Squeeze maneuver: an easy way to manage radiological contrast-medium extravasation. Acta Radiol. 2007;48:605–7. https://doi.org/10.1080/02841850701324094.
Thigpen JL. Peripheral intravenous extravasation: nursing procedure for initial treatment. Neonatal Netw. 2007;26:379–84. https://doi.org/10.1891/0730-0832.26.6.379.
Harrold K, Gould D, Drey N. The efficacy of saline washout technique in the management of exfoliant and vesicant chemotherapy extravasation: a historical case series report. Eur J Cancer Care (Engl). 2013;22(2):169–78. https://doi.org/10.1111/ecc.12023.
Vandeweyer E, Heymans O, Deraemaecker R. Extravasation injuries and emergency suction as treatment. Plast Reconstr Surg. 2000;105:109–10. https://doi.org/10.1097/00006534-200001000-00019.
McBride A. Management of chemotherapy extravasations. US Pharm. 2009;34(Oncology suppl):3–11.
Doellman D, Hadaway L, Bowe-Geddes LA, Franklin M, LeDonne J, Papke-O’Donnell L, Pettit J, Schulmeister L, Stranz M. Infiltration and extravasation: update on prevention and management. J Infus Nurs. 2009;32:203–11. https://doi.org/10.1097/NAN.0b013e3181aac042.
Langer SW. Dexrazoxane for the treatment of chemotherapy-related side effects. Cancer Manag Res. 2014;6:357–63. https://doi.org/10.2147/CMAR.S47238.
Jordan K, Behlendorf T, Mueller F, Schmoll HJ. Anthracycline extravasation injuries: management with dexrazoxane. Therapeutics and clinical risk management. 2009; 5:361. Ther Clin Risk Manag. 2009;5(2):361–6. https://doi.org/10.2147/tcrm.s3694.
El-Saghir N, Otrock Z, Mufarrij A, Abou-Mourad Y, Salem Z, Shamseddine A, Abbas J. Dexrazoxane for anthracycline extravasation and GM-CSF for skin ulceration and wound healing. Lancet Oncol. 2004;5(5):320–1. https://doi.org/10.1016/S1470-2045(04)01470-6.
Hong WK, Bast RC, Hait WN, Kufe DW, Pollock RE, Weichselbaum RR, Holland JF. Cancer medicine, vol. 8. Shelton: PMPHUSA Ltd; 2010.
Salunke AA, Nambi GI, Sudhakar N. Post chemotherapy extravasation injuries: hypogastric flap for reconstruction of wounds over dorsum of hand. J Cancer Res Ther. 2015;11(4):835–9. https://doi.org/10.4103/0973-1482.144589.
Shenaq SM, Abbase EH, Friedman JD. Soft-tissue reconstruction following extravasation of chemotherapeutic agents. Surg Oncol Clin N Am. 1996;5(4):825–45.
Isci E, Canter HI, Dadaci M, Atilla P, Cakar AN, Kecik A. The efficacy of negative pressure wound therapy on chemotherapeutic extravasation ulcers: an experimental study. Indian J Plast Surg. 2014;47(3):394–400. https://doi.org/10.4103/0970-0358.146611.
Goutos I, Cogswell LK, Giele H. Extravasation injuries: a review. J Hand Surg Eur Vol. 2014;39(8):808–18. https://doi.org/10.1177/1753193413511921.
Gill AL, Bell CN. Hyperbaric oxygen: its uses, mechanisms of action and outcomes. QJM. 2004;97(7):385–95. https://doi.org/10.1093/qjmed/hch074.
Cohen SC, Dibella NJ, Michalak JC. Letter: recall injury from adriamycin. Ann Intern Med. 1975;83(2):232. https://doi.org/10.7326/0003-4819-83-2-232_1.
Langstein HN, Duman H, Seelig D, Butler CE, Evans GR. Retrospective study of the management of chemotherapeutic extravasation injury. Ann Plast Surg. 2002;49(4):369–74. https://doi.org/10.1097/00000637-200210000-00006.
D’Andrea F, Onesti MG, Nicoletti GF, et al. Surgical treatment of ulcers caused by extravasation of cytotoxic drugs. Scand J Plast Reconstr Surg Hand Surg. 2004;38(5):288–92. https://doi.org/10.1080/02844310410027383.
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Yadav, P., Mathews, S. (2022). Management of Chemotherapy Infusion Extravasation in Breast Cancer. In: Sharma, S.C., Mazumdar, A., Kaushik, R. (eds) Breast Cancer. Springer, Singapore. https://doi.org/10.1007/978-981-16-4546-4_26
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