The prevention of cutaneous necrosis following extravasation of hypertonic saline and sodium tetradecyl sulfate.
BACKGROUND
Most authors have recommended treating extravasation during sclerotherapy by infiltrating the area with 0.9% sodium chloride and/or procaine.


OBJECTIVE
To evaluate interventions in the prevention of necrosis following intradermal injection of 23.4% sodium chloride and 3% sodium tetradecyl sulfate.


METHODS
Following intradermal 23.4% sodium chloride (Study I) or 3% sodium tetradecyl sulfate (Study II), subjects (Sprague-Dawley rats) received either no treatment or injections of 0.9% sodium chloride, sterile water, 1% procaine, or hyaluronidase. Groups were compared regarding incidence and size of necrosis.


RESULTS
In study I, hyaluronidase treated groups had significantly fewer and smaller areas of necrosis than other groups. In study II, the hyaluronidase group developed significantly fewer ulcers than the 0.9% sodium chloride group. The 0.9% sodium chloride group had significantly larger ulcers than other groups.


CONCLUSIONS
In the model studied, hyaluronidase was the only effective treatment in the prevention of necrosis. Following 3% sodium tetradecyl sulfate, 0.9% sodium chloride was associated with larger ulcers than other groups.
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Animal Resources Center, University of Texas, Austin.
D000818:Animals; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000150:complications* / Q000473:pathology; D005260:Female; D006821:Hyaluronoglucosaminidase / Q000008:administration & dosage / Q000627:therapeutic use*; D015994:Incidence; D007271:Injections, Intradermal; D009336:Necrosis; D011343:Procaine / Q000008:administration & dosage / Q000627:therapeutic use*; D051381:Rats; D017207:Rats, Sprague-Dawley; D012462:Saline Solution, Hypertonic / Q000008:administration & dosage / Q000009:adverse effects*; D012597:Sclerosing Solutions / Q000008:administration & dosage / Q000009:adverse effects*; D012867:Skin / Q000187:drug effects / Q000473:pathology*; D012883:Skin Ulcer / Q000139:chemically induced / Q000473:pathology / Q000517:prevention & control; D012965:Sodium Chloride; D012981:Sodium Tetradecyl Sulfate / Q000008:administration & dosage / Q000009:adverse effects*; D014867:Water
D012462:Saline Solution, Hypertonic; D012597:Sclerosing Solutions; D014867:Water; D012965:Sodium Chloride; D011343:Procaine; D006821:Hyaluronoglucosaminidase; D012981:Sodium Tetradecyl Sulfate