[Emergency management of extravasation in children].
The subcutaneous diffusion of intravenous drips, or extravasation, is a frequent iatrogenic complication in children, mainly in the neonatal period. This potentially severe pathology can lead to local ischemia that sometimes mimics compartment syndrome. It can also evolve towards vast soft-tissue necrosis. Nursing staff often underestimate the risk of functional, aesthetic, and psychological consequences. The speed and quality of the initial medical and surgical management can greatly decrease morbidity associated with extravasation. Prevention is fundamental, such as raising awareness in and training medical and paramedical staffs and creating efficient protocols. Surgical management involving aspiration and washing the site as early as possible improves the prognosis. Aspiration and washing can be done on a larger area if one criteria of severity is met, particularly in cases of extravasation using a vesicant or hyperosmolar agent. If necrotic lesions appear, it is wise to wait until they become delimited. Debridement and coverage can be performed using classical methods.
Service de chirurgie plastique, reconstructrice et esthétique, centre de traitement des brûlés, hôpital Roger-Salengro, CHRU, rue Emile-Laine, 59037 Lille cedex, France. Electronic address: louisepasquesoone@chru-lille.fr.
L
L
Pasquesoone
Service de chirurgie plastique, reconstructrice et esthétique, centre de traitement des brûlés, hôpital Roger-Salengro, CHRU, rue Emile-Laine, 59037 Lille cedex, France.
N
N
Aljudaibi
Service de chirurgie plastique, reconstructrice et esthétique, centre de traitement des brûlés, hôpital Roger-Salengro, CHRU, rue Emile-Laine, 59037 Lille cedex, France.
J
J
Ellart
Service de chirurgie plastique, reconstructrice et esthétique, centre de traitement des brûlés, hôpital Roger-Salengro, CHRU, rue Emile-Laine, 59037 Lille cedex, France.
P
P
Guerreschi
Service de chirurgie plastique, reconstructrice et esthétique, centre de traitement des brûlés, hôpital Roger-Salengro, CHRU, rue Emile-Laine, 59037 Lille cedex, France.
V
V
Duquennoy-Martinot
D001458:Bandages; D002648:Child; D003646:Debridement; D004322:Drainage; D004630:Emergencies; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000150:complications / Q000628:therapy*; D006801:Humans; D012867:Skin / Q000293:injuries*; D014947:Wounds and Injuries / Q000209:etiology* / Q000628:therapy*
Cutaneous necrosis; Extravasation; Ischémie tissulaire; Nécrose cutanée; Prise en charge chirurgicale; Soft-tissue ischemia; Surgical coverage; Traitement; Treatment