Murphy Adrian D, Gilmour Robert F, Coombs Chris J
Department of Plastic and Maxillofacial Surgery, Royal Children's Hospital, Melbourne, Victoria, Australia.
ANZ J Surg. 2019 Apr;89(4):E122-E126. doi: 10.1111/ans.14104. Epub 2017 Jul 6.
Extravasation occurs when a drug is inadvertently administered outside of the vein. Depending on the substance involved, this may lead to tissue necrosis with significant long-term morbidity. Children, particularly neonates, are particularly susceptible to extravasation with up to 70% of children in neonatal intensive care unit having some form of extravasation injury. These injuries are commonly referred to plastic surgeons for ongoing management.
We prospectively collected information on all extravasation injuries referred to the plastic surgery department in a children's hospital over an 18-month period. Data collected included the agent involved in the extravasation, treatment and outcomes.
In total, there were 43 extravasation injuries recorded on the hospital risk management system during the period of this study. All of these were referred to the plastic surgery team for ongoing management. Five patients (11%) underwent washout of their injuries. Three patients (7%) suffered injuries, which led to significant tissue necrosis, delayed healing and prolonged morbidity.
Smaller infants, particularly those being cared for in an intensive care setting, are at increased risk for extravasation injury. Early referral and treatment of high-risk extravasation injuries may reduce the incidence of tissue loss and morbidity.
药物意外注入静脉外时会发生外渗。根据所涉及的物质不同，这可能导致组织坏死并伴有严重的长期发病率。儿童，尤其是新生儿，特别容易发生外渗，新生儿重症监护病房中高达70%的儿童有某种形式的外渗损伤。这些损伤通常会转诊给整形外科医生进行后续治疗。
我们前瞻性收集了一家儿童医院18个月期间转诊至整形外科的所有外渗损伤信息。收集的数据包括外渗所涉及的药物、治疗方法及结果。
在本研究期间，医院风险管理系统共记录了43例外渗损伤。所有这些损伤均转诊至整形外科团队进行后续治疗。5名患者（11%）接受了伤口冲洗。3名患者（7%）受伤，导致严重的组织坏死、愈合延迟和病程延长。
较小的婴儿，尤其是在重症监护环境中接受护理的婴儿，发生外渗损伤的风险增加。早期转诊和治疗高危外渗损伤可能会降低组织丢失和发病率。
