D'Andrea Francesco, Onesti Maria Giuseppina, Nicoletti Giovanni Francesco, Grella Elisa, Renzi Luca Francesco, Spalvieri Cristina, Scuderi Nicolò
Plastic Surgery Department, Second University of Naples, Naples, Italy.
Scand J Plast Reconstr Surg Hand Surg. 2004;38(5):288-92. doi: 10.1080/02844310410027383.
Despite preventive measures, the extravasation of cytotoxic drugs still occurs in 0.6% to 6% of cases. The aetiology is thought to be that tissue necrosis develops into a chronic ulcer, which causes problems if the harmful action of the drug is not blocked. From 1988-2002 at the Department of Plastic Surgery of Rome University "La Sapienza", 240 patients presented with extravasation of cytotoxic drugs; all had been treated with an original conservative protocol first described in 1994, based on the repeated local infiltration of a large quantity of saline solution (90-540 ml) into the area of extravasation. We considered only cases with actively necrotic lesions. Eleven of the 240 patients (5%) had ulcers ranging from small ulcers to extensive areas of tissue necrosis. Of the 11 patients, eight had already had ulcers, while the remaining three were those in whom our conservative protocol had not prevented necrosis. They were all operated on and given grafts, local flaps, reverse radial flaps, and free flaps.
尽管采取了预防措施，但细胞毒性药物外渗仍在0.6%至6%的病例中发生。其病因被认为是组织坏死发展成慢性溃疡，如果药物的有害作用未被阻断，就会引发问题。1988年至2002年期间，罗马大学“La Sapienza”整形外科学系有240例细胞毒性药物外渗患者；所有患者均首先采用1994年首次描述的原始保守方案进行治疗，该方案基于向药物外渗区域反复局部注射大量生理盐水（90 - 540毫升）。我们仅考虑有活动性坏死病变的病例。240例患者中有11例（5%）出现了从小溃疡到广泛组织坏死区域不等的溃疡。在这11例患者中，8例已有溃疡，而其余3例是我们的保守方案未能预防坏死的患者。他们均接受了手术，并接受了植皮、局部皮瓣、逆行桡侧皮瓣和游离皮瓣治疗。
