MANAGEMENT OF EXTRAVASATION INJURY

10 patients were treated with the diagnosis of chemotherapy extravasation between 1994-1997 years in Plastic Surgery Department of Şişli Etfal Hospital. The patients were evaluated in points of age, diagnosis of primary illness, localization of extravasation, responsible chemotherapeutic agent, time elapse between injury and our first assesment. The treatment protocol was planned according to the admission time and the physical signs and symptoms. 5 of 10 patients were firstly examined in acute phase, and other 5 patients in chronic phase. Patients who admitted in acute phase were managed immediately with intermittent ice application, elevation and splintting of the involved extremity and removal of agent by the liposuction technique in 2 patients. Chemotherapy regime was not interrupted in this group. In only 1 case, progression into tissue necrosis was observed and treated by local wound care. All of the patients admitted in chronic phase were presented with soft tissue defect, and managed with early, wide, three dimensional excision of all involved tissues and simultaneous reconstruction by split thickness skin graft for 3 patients and skin flap for 2 patients. Having restarted chemotherapy programme; 15 days after operation; 1 partial, 1 total wound healing deterioration were observed in patients treated with grafts and no deterioration was observed in patients treated with flaps. In conclusion; after a suspected or actual chemotherapy extravasation, early assesment of patient by plastic surgery clinics and management by the recommended protocol will be a suitable approach. The aim of which is to prevent progression into tissue necrosis.