Extravasations of radiographic contrast material in the upper extremity

Five significant extravasations of radiographic contrast material in the upper extremity were treated with early surgical drainage in an attempt to prevent extensive skin necrosis. Four of the five patients underwent operation within 6 hours of the extravasations, and all of these patients had excellent functional and cosmetic results without any evidence of skin necrosis. One patient who had a poor result did not undergo operation until 20 hours after a severe extravasation to the dorsum of the right hand. Most small-volume, less-extensive extravasations can be satisfactorily managed conservatively. Our clinical experience indicates that large subcutaneous extravasations of radiographic contrast material (volume more than 20 ml) should be surgically drained within 6 hours to prevent extensive damage to tissue.