Bowers D G, Lynch J B
Plast Reconstr Surg. 1978 Jan;61(1):86-92. doi: 10.1097/00006534-197801000-00015.
Adriamycin extravasation creates a severe tissue necrosis which is unusual, because it may not appear until several weeks later, and may continue to worsen for several months. As soon as the progressive nature of the tissue necrosis is established, we recommend that an early wide excision be performed in an attempt to remove the necrotic area and the surrounding tissues containing the extravasated drugs--before it has had an opportunity to diffuse even further. Adequate debridement requires removal of any adjacent tissue that is indurated, reddened, edematous, or pale. Skin grafts take poorly if there are small amounts of Adriamycin left in the tissue of the recipient site. Synergistic effects with radiotherapy, and continued systemic Adriamycin therapy, can aggravate or recall necrosis. The administration of more dilute solutions of Adriamycin may decrease the hazard of extravasation necrosis.
阿霉素外渗会导致严重的组织坏死，这种情况较为特殊，因为它可能在数周后才出现，并且可能会持续恶化数月。一旦确定组织坏死呈进行性发展，我们建议尽早进行广泛切除，试图在坏死区域及含有外渗药物的周围组织进一步扩散之前将其切除。充分的清创需要切除任何变硬、发红、水肿或苍白的相邻组织。如果受区组织中残留少量阿霉素，皮肤移植效果会很差。放疗的协同作用以及持续的全身阿霉素治疗会加重或引发坏死。使用更稀释的阿霉素溶液可能会降低外渗坏死的风险。
