Taibi Abdelkader, Bardet M Sylvia, Durand Fontanier Sylvaine, Deluche Elise, Fredon Fabien, Christou Niki, Usseglio Julie, Mathonnet Muriel
Visceral Surgery Department, Dupuytren University Hospital, Limoges, France.
University Limoges, CNRS, XLIM, UMR 7252, Limoges, France.
J Vasc Access. 2020 Sep;21(5):723-731. doi: 10.1177/1129729820905174. Epub 2020 Feb 14.
Totally implanted venous access is widely used in chemotherapy administration. With over 1 million intravenous chemotherapy infusions given worldwide each day, complications are frequent. Accidental cases of extravasation in the presence of a catheter are rare yet very serious and may require discontinuation of chemotherapy. The aim of this study was to evaluate the feasibility and efficacy of the subcutaneous wash-out technique for chemotherapy extravasation treatment.
We retrospectively reviewed the medical charts of patients who had received chemotherapy and sustained extravasation in our hospital between October 2013 and October 2016. Subcutaneous wash-out treatments were carried out exclusively, without the application of antidotes or the use of specific antidotes.
We documented seven cases of chemotherapy extravasation. Two cases were treated with antidotes and suffered necrosis in the following weeks. The five patients treated using subcutaneous wash-out had no necrosis and had a steady decrease in the inflammatory reaction of the cutaneous and subcutaneous soft tissues. For these five patients, chemotherapy was restarted within 1 month following extravasation.
This study would argue for the feasibility and effectiveness of subcutaneous wash-out in the treatment of chemotherapy extravasations.
完全植入式静脉通路在化疗给药中广泛应用。全球每天有超过100万例静脉化疗输注，并发症很常见。导管存在时意外发生外渗的情况虽罕见但非常严重，可能需要停止化疗。本研究的目的是评估皮下冲洗技术治疗化疗外渗的可行性和有效性。
我们回顾性分析了2013年10月至2016年10月期间在我院接受化疗并发生外渗的患者的病历。仅进行皮下冲洗治疗，不使用解毒剂或特定解毒剂。
我们记录了7例化疗外渗病例。2例使用了解毒剂治疗，在接下来的几周内出现坏死。采用皮下冲洗治疗的5例患者未出现坏死，皮肤和皮下软组织的炎症反应持续减轻。对于这5例患者，外渗后1个月内重新开始化疗。
本研究支持皮下冲洗治疗化疗外渗的可行性和有效性。
