Extravasation injury treatment

There is little information on the treatment of extravasation of paclitaxel, as it has not been common during clinical trials. However, a soft-tissue injury occurred in one patient at the site of previous extravasation after treatment with paclitaxel in a different Umb (42). This resolved within 7 days. 

Skin Local venous effects, including erythema, tenderness, and discomfort, can occur at the injection site during paclitaxel infusion [34 ]. Inflammation is usually evident within hours and normally resolves within 21 days. Inflammation occurs in areas of drug extravasation along with prolonged soft tissue injuries. Necrotic changes have been reported in one patient at the site of extravasation [62 ]. A soft tissue injury occurred in one patient at the site of previous extravasation after treatment with paclitaxel in a different limb [63 j. This resolved within 7 days. Inflammation is most likely to be due to the drug, but the Cremophor EL vehicle may also be implicated, as it produces mild inflammation in animals. 

Extravasation of polymorphonuclear leukocytes (PMNs) in the area of injury occurs very early after injury in several different models of experimental TBI, and has been shown to correlate with the development of cerebral edema (101,102). Early canine studies conducted by Rosomoff (16,57) demonstrated that treatment with hypothermia decreased the posttraumatic cellular inflammatory response incited by experimental head injury compared to normothermic controls. This effect of hypothermia is likely mediated by several mechanisms including preservation of the BBB, thereby limiting extravasation of inflammatory cells and mediators into the area of injury (103), suppressing release of cytokines (22), and reducing CBF. 

Shapiro J, Richardson GE. Pachtaxel-induced recall soft tissue injury occurring at the site of previous extravasation with subsequent intravenous treatment in a different hmb. J Clin Oncol 1994 12(10) 2237-8. 

Dimethyl sulfoxide has also been investigated as a potential therapeutic agent in conditions such as scleroderma, interstitial cystitis, rheumatoid arthritis, and acute musculoskeletal injuries, and as an analgesic. It has also been recommended for the treatment of anthracycline extravasation and has been investigated as a potential cryoprotectant. ... 

Lesions of the anterior urethra are more frequent than those of the posterior urethra. Complications of anterior urethral injuries include infections and strictures. Most of the urethral strictures will necessitate surgical treatment also many months later. Moreover, extravasion of urine could cause fibrosis of the corpus spongiosum. Incontinence and impotence are uncommon complications. 

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