title: Localised bullous eruptions and epidermal detachment from the extravasation of hydroxyethyl starch (Voluven).
abstract: Extravasation occurs frequently with intravenous infusions. In this case report we describe the occurrence of epidermal detachment and multiple cutaneous bullous eruptions in a patient's forearm following the extravasation of hydroxyethyl starch (Voluven, Fresenius Kabi)-a colloid solution derived from corn starch, which is used to replace lost blood volume. The patient's affected body surface area was managed under the direction of our plastic surgical team. Despite a prolonged admission in hospital from other perioperative complications, he made a full recovery and was successfully discharged home. The probable pathogenesis relevant to extravasation of Voluven is discussed; as well as its management principles.
authors.affiliation: Department of Anaesthesia, Flinders Medical Centre, Bedford Park, South Australia, Australia.
authors.forename: James
authors.initials: J
authors.lastname: London
authors.affiliation: Department of Anaesthesia, Royal Darwin Hospital, Tiwi, Northern Territory, Australia.
authors.forename: Stan
authors.initials: S
authors.lastname: Tay
authors.affiliation: Department of Anaesthesia, Royal Darwin Hospital, Tiwi, Northern Territory, Australia.
authors.forename: Brigid
authors.initials: B
authors.lastname: Brown
authors.affiliation: Department of Medicine, St Vincent's Hospital, Fitzroy, Victoria, Australia.
authors.forename: Chasari
authors.initials: C
authors.lastname: Tancharoen
mesh_terms: D000368:Aged; D001810:Blood Volume; D004817:Epidermis / Q000473:pathology*; D005542:Forearm; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives / Q000008:administration & dosage / Q000009:adverse effects*; D007262:Infusions, Intravenous / Q000009:adverse effects; D008297:Male; D012871:Skin Diseases / Q000209:etiology*; D012872:Skin Diseases, Vesiculobullous / Q000209:etiology
chemical_list: C485123:HES 130-0.4; D006895:Hydroxyethyl Starch Derivatives