Deep dopamine extravasation injury: a case report.
We report the case of a 3-month-old girl with Down's syndrome, who sustained a deep and massive extravasation of dopamine, resulting in segmented, full-thickness skin necrosis and transient brachial plexus palsy of her left upper extremity. The patient was managed conservatively, including wound care, de-bridement of necrotic tissue, secondary wound healing and intensive physical therapy. The patient showed a satisfactory outcome with complete secondary closure of her wounds and full brachial plexus recovery after 1 year of follow-up. The mechanism of action of dopamine in the deep soft tissue, the difficulties of an adequate diagnosis of a deep dopamine extravasation and alternative treatments are presented in this article.
Phillips
Reid A
RA
UAB Cleft and Craniofacial Center, Division of Plastic Surgery, Department of Surgery, University of Alabama at Birmingham, 35233, USA.
Andrades
Patricio
P
Grant
John H
JH
Ray
Peter D
PD
D001132:Arm / Q000601:surgery; D001916:Brachial Artery / Q000601:surgery; D001917:Brachial Plexus; D002316:Cardiotonic Agents / Q000009:adverse effects*; D004298:Dopamine / Q000009:adverse effects*; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000150:complications*; D005260:Female; D006801:Humans; D007223:Infant; D009336:Necrosis / Q000139:chemically induced / Q000628:therapy; D010291:Paresis / Q000139:chemically induced / Q000601:surgery; D020127:Recovery of Function; D013530:Surgical Wound Infection / Q000601:surgery; D016896:Treatment Outcome
D002316:Cardiotonic Agents; D004298:Dopamine