Antitumor agents: extravasation, management, and surgical treatment

We discuss our experience with antineoplastic drug extravasation. Between December 1988 and December 1990, 40 patients with cytostatic extravasation with lesions of varying seriousness were observed. In these patients, whenever possible, depending on the amount of time that elapsed since the accident and on the severity of the lesion, conservative therapy was done. The procedure consisted of local injection of a considerable amount of saline solution (20-90 ml, depending on the site of extravasation) and topical occlusive applications of corticosteroids locally. In all patients this was sufficient to avoid tissue necrosis. Treatment of a few patients deviated from these procedures because surgery was performed that ranged from the simple excision of infiltrated tissue to a more complex procedure of free flaps. On the basis of our experience, we discuss the role of early surgery when preventive measures and drug therapy are insufficient because of drug effects at the tissue level. In this series we did not perform early surgery.