title: Use of subatmospheric pressure to prevent doxorubicin extravasation ulcers in a swine model.
abstract: Application of subatmospheric pressure to sites injected with doxorubicin prevented ulcer formation in treated sites (0 ulcers/16 sites) compared to control wounds (10 ulcers/16 sites) in a pig model.
  
  
  OBJECTIVE
  Extravasation of doxorubicin hydrochloride (Adriamycin) frequently causes chronic ulcers, which usually progress and expose underlying structures such as tendons and bone. The exact mechanism of action that causes cell death and the chronic ulcers is unknown.
  
  
  METHODS
  Eight sites were injected intradermally with doxorubicin on each of 4 pigs. Four sites on each animal served as untreated controls. The remaining four sites were exposed to 125 mm Hg subatmospheric pressure applied 1 h after injection. The sites were observed on a three times per week schedule. Sites that did not develop ulcers were re-injected up to a total of four injections. The animals were observed for 5 weeks.
  
  
  RESULTS
  Ten of sixteen control sites developed ulcers. No subatmospheric pressure treated sites developed ulcers. The incidence of ulcer formation was significantly less for treated wounds compared to control wounds at P < 0.001 by Fisher's exact test.
  
  
  CONCLUSIONS
  This physical modality appears to successfully prevent ulcer formation after doxorubicin injection.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Wake Forest University School of Medicine, Winston-Salem, North Carolina 27157-1075, USA. mmorykwa@wfubmc.edu
authors.forename: M J
authors.initials: MJ
authors.lastname: Morykwas
authors.forename: A
authors.initials: A
authors.lastname: Kennedy
authors.forename: J P
authors.initials: JP
authors.lastname: Argenta
authors.forename: L C
authors.initials: LC
authors.lastname: Argenta
mesh_terms: D000818:Animals; D002908:Chronic Disease; D004195:Disease Models, Animal; D004317:Doxorubicin / Q000009:adverse effects*; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000150:complications*; D013552:Swine; D014456:Ulcer / Q000209:etiology / Q000517:prevention & control*; D014618:Vacuum
chemical_list: D004317:Doxorubicin