title: Computed tomography contrast media extravasation: treatment algorithm and immediate treatment by squeezing with multiple slit incisions.
abstract: In our hospital, an adverse event reporting system was initiated that alerts the plastic surgery department immediately after suspecting contrast media extravasation injury. This system is particularly important for a large volume of extravasation during power injector use. Between March 2011 and May 2015, a retrospective chart review was performed on all patients experiencing contrast media extravasation while being treated at our hospital. Immediate treatment by squeezing with multiple slit incisions was conducted for a portion of these patients. Eighty cases of extravasation were reported from approximately 218 000 computed tomography scans. The expected extravasation volume was larger than 50 ml, or severe pressure was felt on the affected limb in 23 patients. They were treated with multiple slit incisions followed by squeezing. Oedema of the affected limb disappeared after 1-2 hours after treatment, and the skin incisions healed within a week. We propose a set of guidelines for the initial management of contrast media extravasation injuries for a timely intervention. For large-volume extravasation cases, immediate management with multiple slit incisions is safe and effective in reducing the swelling quickly, preventing patient discomfort and decreasing skin and soft tissue problems.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Ajou University School of Medicine, Suwon, Republic of Korea.
authors.forename: Sue Min
authors.initials: SM
authors.lastname: Kim
authors.affiliation: Department of Plastic and Reconstructive Surgery, Ajou University School of Medicine, Suwon, Republic of Korea.
authors.forename: Kyung Hoon
authors.initials: KH
authors.lastname: Cook
authors.affiliation: Department of Plastic and Reconstructive Surgery, Ajou University School of Medicine, Suwon, Republic of Korea.
authors.forename: Il Jae
authors.initials: IJ
authors.lastname: Lee
authors.affiliation: Department of Plastic and Reconstructive Surgery, Ajou University School of Medicine, Suwon, Republic of Korea.
authors.forename: Dong Ha
authors.initials: DH
authors.lastname: Park
authors.affiliation: Department of Plastic and Reconstructive Surgery, Ajou University School of Medicine, Suwon, Republic of Korea.
authors.forename: Myong Chul
authors.initials: MC
authors.lastname: Park
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D003287:Contrast Media / Q000009:adverse effects*; D004487:Edema / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy*; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000150:complications* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D013518:Surgery, Plastic / Q000592:standards*; D014057:Tomography, X-Ray Computed
chemical_list: D003287:Contrast Media
keywords: Complications; Contrast Media; Extravasation; Tomography