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Chemotherapy Extravasation Management: 21-Year Experience.

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Chemotherapy extravasation can cause severe local injury. A standardized protocol using saline solution infiltration and corticosteroid applications effectively prevented ulceration in most patients, reducing the need for surgery.

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Area of Science:

  • Oncology
  • Patient Safety
  • Pharmacology

Background:

  • Chemotherapy extravasation causes severe local tissue damage and disability.
  • Lack of standardized management protocols contributes to inadequate prevention and treatment.
  • Existing treatments, including antidotes, are controversial and may not be feasible with polychemotherapy.

Purpose of the Study:

  • To explore prevention and treatment strategies for chemotherapy extravasation injuries.
  • To propose a standardized therapeutic protocol based on literature review and case studies.
  • To evaluate the efficacy of the proposed protocol in preventing severe damage.

Main Methods:

  • Reviewed 545 cases of chemotherapy extravasation from January 1994 to December 2015.
  • Implemented a therapeutic protocol involving local saline solution infiltration and topical corticosteroids.
  • Administered infiltrations 3-6 times weekly based on injury severity.

Main Results:

  • The protocol prevented ulceration in 373 out of 545 cases.
  • Only 27 patients required surgical intervention (escarectomy, skin graft, flap).
  • Saline solution injection effectively diluted extravasated drugs, reducing local toxicity.

Conclusions:

  • The proposed protocol of saline infiltration and corticosteroid application is an effective method for managing chemotherapy extravasation.
  • This standardized, reproducible method is suitable even for unknown or combined chemotherapy agents.
  • The protocol can be administered in an ambulatory setting, representing a standardizable approach to minimize patient injury.