title: [Serious complications of injections--retrospective analysis of incidences, complication-management, prophylaxis and economic aspects].
abstract: The parenteral drug application is a routinely used method in all medical disciplines. Intramuscular, intraarticular, intravenous injections and infusions can cause local complications such as abscesses, articular infections or paravasates. These local complications can lead to bacteraemia, sepsis and may lead to multiple organ failure associated with high morbidity and mortality. Although these complications are rare, they are sometimes disastrous and result in life threatening clinical conditions. During a retrospective analysis (review period 1998-2002) 24 patients were admitted and hospitalized in our department. Within this report we demonstrate 7 patients with fatal complications after injections. In the majority of cases minor patients' complaints were proceeding before major complications were present. A long and expensive treatment period with multiple surgical interventions ends up in functional disabilities and unsatisfactory aesthetic results. Instead of delayed surgical treatment immediate radical surgical care is crucial to prevent disastrous complications. In case of the inability of sufficient debridement, amputations are sometimes indicated in the sense of "life before limb". Besides the consequences for the patient these disastrous complications have a high socioeconomic impact and result in reduced reimbursement for the hospital stay.
authors.affiliation: Universitätsklinik für Plastische Chirurgie und Schwerbrandverletzte, Handchirurgiezentrum, Operatives Zentrum für Gliedmassentumoren, Bochum. marcus.lehnhardt@rub.de
authors.forename: M
authors.initials: M
authors.lastname: Lehnhardt
authors.forename: P
authors.initials: P
authors.lastname: Vu
authors.forename: C
authors.initials: C
authors.lastname: Kuhnen
authors.forename: L
authors.initials: L
authors.lastname: Steinstraesser
authors.forename: T
authors.initials: T
authors.lastname: Muehlberger
authors.forename: D
authors.initials: D
authors.lastname: Druecke
authors.forename: H U
authors.initials: HU
authors.lastname: Steinau
authors.forename: H-H
authors.initials: HH
authors.lastname: Homann
mesh_terms: D000038:Abscess / Q000209:etiology / Q000601:surgery; D000293:Adolescent; D000328:Adult; D000368:Aged; D000671:Amputation, Surgical; D003646:Debridement; D019115:Fasciitis, Necrotizing / Q000209:etiology / Q000601:surgery; D005260:Female; D006801:Humans; D007267:Injections / Q000009:adverse effects* / Q000401:mortality; D007269:Injections, Intra-Arterial / Q000009:adverse effects; D007273:Injections, Intramuscular / Q000009:adverse effects; D007275:Injections, Intravenous / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D011677:Punctures / Q000009:adverse effects; D017534:Radial Artery; D019651:Plastic Surgery Procedures / Q000191:economics; D012189:Retrospective Studies; D016038:Skin Transplantation; D017695:Soft Tissue Injuries / Q000209:etiology / Q000601:surgery; D013524:Surgical Flaps; D013923:Thromboembolism / Q000209:etiology / Q000601:surgery; D016896:Treatment Outcome