Kim Sue Min, Cook Kyung Hoon, Lee Il Jae, Park Dong Ha, Park Myong Chul
Department of Plastic and Reconstructive Surgery, Ajou University School of Medicine, Suwon, Republic of Korea.
Int Wound J. 2017 Apr;14(2):430-434. doi: 10.1111/iwj.12628. Epub 2016 Jul 19.
In our hospital, an adverse event reporting system was initiated that alerts the plastic surgery department immediately after suspecting contrast media extravasation injury. This system is particularly important for a large volume of extravasation during power injector use. Between March 2011 and May 2015, a retrospective chart review was performed on all patients experiencing contrast media extravasation while being treated at our hospital. Immediate treatment by squeezing with multiple slit incisions was conducted for a portion of these patients. Eighty cases of extravasation were reported from approximately 218 000 computed tomography scans. The expected extravasation volume was larger than 50 ml, or severe pressure was felt on the affected limb in 23 patients. They were treated with multiple slit incisions followed by squeezing. Oedema of the affected limb disappeared after 1-2 hours after treatment, and the skin incisions healed within a week. We propose a set of guidelines for the initial management of contrast media extravasation injuries for a timely intervention. For large-volume extravasation cases, immediate management with multiple slit incisions is safe and effective in reducing the swelling quickly, preventing patient discomfort and decreasing skin and soft tissue problems.
在我院，启动了一个不良事件报告系统，该系统在怀疑造影剂外渗损伤后立即提醒整形外科。对于使用动力注射器期间大量的外渗情况，此系统尤为重要。2011年3月至2015年5月，对我院所有在接受治疗时发生造影剂外渗的患者进行了回顾性病历审查。对其中部分患者进行了通过多处切开挤压的即时治疗。在约218000次计算机断层扫描中报告了80例外渗情况。有23例患者预期外渗量大于50毫升，或患侧肢体感到严重压迫。对他们进行了多处切开挤压治疗。治疗后1 - 2小时患侧肢体水肿消失，皮肤切口在一周内愈合。我们提出了一套造影剂外渗损伤初始处理的指南，以便及时干预。对于大量外渗病例，采用多处切开进行即时处理在迅速减轻肿胀、防止患者不适以及减少皮肤和软组织问题方面是安全有效的。
