title: [Emergency open surgical treatment of extravasations of cytostatic agents in the upper extremity].
abstract: Extravasations of cytostatic agents can create necrosis of soft tissues in the hand and forearm. The early emergency subcutaneous "wash-out" with liposuction is the treatment of choice to avoid the development of soft-tissue defects. The objective of this study was to evaluate the open surgical debridement as a possible alternative method since the liposuction device is not commonly available in every hospital. In our study 10 patients were treated for extravasations of cytostatic drugs with a high potential for necrosis by emergency open debridement. All patients were evaluated prospectively by photography and clinical examination. 9 patients out of ten had a primary wound healing, one displayed a wound dehiscence with pre-existing MRSA infection. Another patient developed a seroma postoperatively which was treated by puncture. The mean functional outcome was good. The Eemergency open surgical treatment is a simple, in every hospital suitable therapy to prevent soft-tissue necrosis after extravasation of cytostatic drugs.
authors.affiliation: Barmherzige Brüder Regensburg, Unfallchirurgie, Orthopädie, Hand- und wiederherstellnde Chir., Sportmedizin, Regensburg. pantelisselis@aol.com
authors.forename: P
authors.initials: P
authors.lastname: Telisselis
authors.forename: G
authors.initials: G
authors.lastname: Heers
authors.forename: B
authors.initials: B
authors.lastname: Plock
authors.forename: C
authors.initials: C
authors.lastname: Baier
authors.forename: R
authors.initials: R
authors.lastname: Neugebauer
authors.forename: B
authors.initials: B
authors.lastname: Füchtmeier
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000633:toxicity*; D003646:Debridement / Q000379:methods*; D062109:Dermatologic Surgical Procedures; D004322:Drainage; D004550:Elbow / Q000601:surgery*; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000601:surgery*; D005218:Fat Necrosis / Q000139:chemically induced*; D005260:Female; D005500:Follow-Up Studies; D005542:Forearm / Q000601:surgery*; D006225:Hand / Q000601:surgery*; D006801:Humans; D008297:Male; D055624:Methicillin-Resistant Staphylococcus aureus; D008875:Middle Aged; D010147:Pain Measurement; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000209:etiology* / Q000601:surgery; D012086:Reoperation; D012867:Skin / Q000187:drug effects*; D013203:Staphylococcal Infections / Q000209:etiology / Q000601:surgery; D040521:Subcutaneous Tissue / Q000187:drug effects* / Q000601:surgery*; D013529:Surgical Wound Dehiscence / Q000601:surgery; D013530:Surgical Wound Infection / Q000209:etiology / Q000601:surgery; D007507:Therapeutic Irrigation
chemical_list: D000970:Antineoplastic Agents