Chirurgische Behandlung von Paravasaten
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Chirurgische Behandlung von Paravasaten. / Goertz, O.; Hirsch, T.; Ring, A.; Daigeler, A.; Hauser, J.; Langer, S.; Steinstraesser, L.; Steinau, H. U.
I: Zentralblatt fur Chirurgie - Zeitschrift fur Allgemeine, Viszeral- und Gefasschirurgie, Bind 139, Nr. Supplement 2, 12.2014, s. e103-e108.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Chirurgische Behandlung von Paravasaten
AU - Goertz, O.
AU - Hirsch, T.
AU - Ring, A.
AU - Daigeler, A.
AU - Hauser, J.
AU - Langer, S.
AU - Steinstraesser, L.
AU - Steinau, H. U.
PY - 2014/12
Y1 - 2014/12
N2 - Objective:Extravasations account for most iatrogenic injuries. The aim of the study was to analyse the results of surgery in patients with extravasations and to draw conclusions for future treatment.Materials and Methods:24 patients with soft-tissue defects after extravasations were treated between 1999 and 2009 in our hospital. The cases were analysed retrospectively. We looked at the drugs causing tissue necrosis and the localisation in relation to the number of interventions and reconstruction complexity.Results:In 83 % (n = 20) of cases tissue necrosis was caused by chemotherapeutic agents, in 8 % (n = 2) by contrast mediums and in 4 % (n = 1) by antibiotics and insulin. 70 % of the cases involved the upper extremity, in 30 % the thoracic wall was affected. 38 % of the extravasations occurred over venous access ports. In mean 2 ± 1.5 interventions were necessary for defect coverage. Two patients died as a direct result of the extravasations, one due to sepsis originating from an infected necrosis area and one due to right-heart failure with prior pulmonary damage.Conclusion: Most extravasations can be treated without surgery. In cases of toxic extravasations or pressure-caused ischaemia rapid surgical intervention is necessary to prevent the necrosis progressing to deeper tissue layers.
AB - Objective:Extravasations account for most iatrogenic injuries. The aim of the study was to analyse the results of surgery in patients with extravasations and to draw conclusions for future treatment.Materials and Methods:24 patients with soft-tissue defects after extravasations were treated between 1999 and 2009 in our hospital. The cases were analysed retrospectively. We looked at the drugs causing tissue necrosis and the localisation in relation to the number of interventions and reconstruction complexity.Results:In 83 % (n = 20) of cases tissue necrosis was caused by chemotherapeutic agents, in 8 % (n = 2) by contrast mediums and in 4 % (n = 1) by antibiotics and insulin. 70 % of the cases involved the upper extremity, in 30 % the thoracic wall was affected. 38 % of the extravasations occurred over venous access ports. In mean 2 ± 1.5 interventions were necessary for defect coverage. Two patients died as a direct result of the extravasations, one due to sepsis originating from an infected necrosis area and one due to right-heart failure with prior pulmonary damage.Conclusion: Most extravasations can be treated without surgery. In cases of toxic extravasations or pressure-caused ischaemia rapid surgical intervention is necessary to prevent the necrosis progressing to deeper tissue layers.
KW - chemotherapy
KW - contrast medium
KW - defect closure
KW - extravasation
KW - soft-tissue defect
U2 - 10.1055/s-0030-1262696
DO - 10.1055/s-0030-1262696
M3 - Tidsskriftartikel
C2 - 21294083
AN - SCOPUS:79551544617
VL - 139
SP - e103-e108
JO - Zentralblatt für Chirurgie
JF - Zentralblatt für Chirurgie
SN - 0044-409X
IS - Supplement 2
ER -
ID: 248230594