• Archives of Reconstructive Microsurgery
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• 제23권1호
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• pp.36-39
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• 2014

Extravasation injury refers to leakage of corrosive liquids from veins, resulting in tissue damage. The authors report on a case of extravasation injury to the left hand after administration of fluid to the antecubital area in a patient with brain damage. In order to minimize the effects of extravasation injury, rapid diagnosis and management are needed. In patients with stiffness, pressure sores can develop requiring more careful management by the medical staff.

• Archives of Plastic Surgery
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• 제36권3호
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• pp.269-276
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• 2009

Purpose: Local skin necrosis after extravasation of adriamycin, a widely used chemotherapeutic agent, is a common problem in cancer patients. The extravasation of chemotherapeutic agents yields severe inflammatory responses, crust formation, skin necrosis, and ulceration. Even though several treatment options have been proposed for extravasation injury, there is still controversy regarding the management of such lesions. Thus the aim of this study was to compare the efficacy of saline injection(Group 1), hydrocortisone injection(Group 2), propranolol injection(Group 3) and early surgical excision as a treatment(Group 4) in a rat extravasation model. Methods: The authors planned forty mature male Sprague - Dawley rats were divided into 4 groups and each group contained 10 rats. Administration of adriamycin($1.0mg/m{\ell}$) $1.5m{\ell}$ by subcutaneous injection on the dorsal side of the rats was followed by protocol. The treatment options were applied 2 hours after adriamycin injection. At the end of the 5th days, the presence and size of ulcers at the injection site were measured. 3 weeks after injection, a histopathologic examination was performed for each treatment and control group. T - tests were used to analyze the differences between the measurements. Results: Propranolol significantly improved tissue recovery compared with control group and other groups. These data suggest that there is little role for saline and hydrocortisone in the treatment of adriamycin extravasation injury. Conclusion: In this study, we compared some treatment methods in adriamycin extravasation model. The findings support the propranolol injection may prevent extravasation injury. However this study was performed in the laboratory using rats, and the results could be different in clinical application. Thus, more needs further investigations and clinical application.

• 한국콘텐츠학회논문지
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• 제6권5호
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• pp.145-152
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• 2006

전산화단층촬영에서 자동주입기에 의한 방사선 조영제의 혈관외유출(140mL)이 우측 손등의 IV 카테터 부위에서 발생하였다. 혈관외유출은 부종 및 괴사를 동반하였고, 구획증후군으로 발전하였다. 혈관외유출 부위를 MDCT로 스캔하여, 3D 재구성 영상인 MPR, MIP, volume rendering으로 재구성하였다. 이러한 3D 재구성 영상은 조영제의 혈관외유출 부위를 침범 정도를 정확하게 확인하여 환자 예방의 필요성 및 사후 조치에 적절한 치료 및 수술 계획에 유용하게 이용될 수 있다.

• 대한방사선기술학회지:방사선기술과학
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• 제30권3호
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• pp.281-287
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• 2007

전산화단층촬영에서 조영제를 자동주입기로 주입하는 과정에서 발생하는 혈관외유출은 조직의 괴사 및 손상의 원인이 되고 있다. 대량의 혈관외유출은 구획증후군으로 발전하여 근막절개술을 시행하는 경우가 발생한다. 혈관외유출이 발생한 환자를 대상으로 혈관외유출 범위 및 부위 정도를 평가하기 위해 CT 검사에서 경정맥에 조영제을 주입하는 과정에서 혈관외유출이 발생한 환자를 대상으로 하였다. 조영제에 의한 혈관외유출 범위 및 손상을 확인하기 조영제 주입부위의 목 및 가슴의 부위를 MDCT를 이용하여 스캔하였다. 경정맥 주사부위의 혈관외유출부위를 MPR, MIP와 볼륨 렌더링의 3차원영상을 3D 프로그램을 이용하여 묘출하였다. 3차원 재구성 영상은 높은 해상력과 정확도를 제공하여 혈관외유출 범위 및 부위를 확인 하여, 환자의 예방의 필요성 및 사후 조치 및 적절한 치료와 수술 계획에 유용하게 이용될 것으로 기대된다.

• Journal of Trauma and Injury
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• 제22권2호
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• pp.199-205
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• 2009

Purpose: This study compared the characteristics of and the prognosis for intraperitoneal and retroperitoneal/pelvic contrast extravasation, which had been confirmed by enhanced abdominal CT scan, after blunt trauma in patients who had undergone angiographic embolization. Methods: From January 2001 to March 2009, data were retrospectively collected regarding patients who had undergone contrast extravasation (CE) on CT scanning and arterial embolization after blunt trauma. The study patient group was divided into the intraperitoneal and the retroperitoneal/pelvic groups according to the area of contrast extravasation. We reviewed the initial demographic data, the location of injury, the solid organ injury, the embolized vessel, and the clinical outcome. Results: The mean age of the study subjects was $40.2{\pm}2.6$ years old, and there were 24 male patients. The intraperitoneal group included 10 patients, and retroperitoneal/pelvic group was comprised of 17 patients. The amount of transfusion from presentation to intervention and during the first 24 hours was greater in the retroperitoneal/pelvic group than in the intraperitoneal group. The intraperitoneal group showed a higher frequency and severity of liver injury than the retroperitoneal/pelvic group. Angiography revealed that the hepatic artery (n=4) was the most frequently embolized vessel in the intraperitoneal group, while the internal iliac artery (n=6), followed by the renal artery (n=4), internal pudendal artery (n=3), and the gluteal artery (n=2), were the most frequently injured vessels in the retroperitoneal/pelvic group. Conclusion: In patients with intra-abdominal contrast extravasation found on CT scanning and arterial embolization after blunt trauma, the need for transfusion was less in the intra-abdominal group than in the retroperitoneal/pelvic group. Liver injury was also more frequent and severe in the intraperitoneal group than in the retroperitoneal/pelvic group.

• 임상간호연구
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• 제28권1호
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• pp.13-22
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• 2022

Purpose: Extravasation of diagnostic and therapeutic materials might occur when the intravascular solution leaks into the surrounding tissues. Injury associated with extravasation depends on various factors. It may range from mild skin reaction to severe necrosis. However, the incidence rate for extravasation is largely unknown because of the limited reporting in Korea. Therefore, this study was conducted to identify the incidence of extravasation and nurses' attitude and knowledge of extravasation for providing high-quality nursing care. Methods: Three acute care hospitals were surveyed to estimate the occurrence of extravasation. Knowledge and attitude toward extravasation were investigated from 793 nurses working in six hospitals. Results: The incidence rate of extravasation was 0.5%. Extravasation commonly occurred in elderly patients aged 66 or older (59.9%) and internal medicine (48.2%), and it happened 13.73±20.68 days after hospitalization on average. It mostly occurred in the forearm site (52.9%) and was mainly caused by parenteral nutrition (33.6%). The mean scores of nurses' knowledge and attitude were 14.63±2.86 and 28.91±36.00, respectively. There was a significant negative correlation between the subjects' knowledge and attitude (r=-.11, p=.002). Conclusion: It is necessary to have a reporting system that can accurately monitor the occurrence of extravasation for patient safety management. In addition, it is necessary to develop a protocol that can be applied to clinical practice and a nurse education program.

• Clinical and Experimental Pediatrics
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• 제58권11호
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• pp.454-458
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• 2015

Compartment syndrome is a rare but devastating condition that can result in permanent neuromuscular or soft tissue injuries. Extravasation injuries, among the iatrogenic causes of compartment syndrome, occur under a wide variety of circumstances in the inpatient setting. Total parenteral nutrition via a peripheral route is an effective alternative for the management of critically ill children who do not obtain adequate nutrition via the oral route. However, there is an inherent risk of extravasation, which can cause compartment syndrome, especially when detected at a later stage. Herein, we report a rare case of compartment syndrome and skin necrosis due to extravasation, requiring emergency fasciotomy and skin graft in a 7-month-old boy who was treated with peripheral parenteral nutrition via a pressurized infusion pump. Although we cannot estimate the exact time at which extravasation occurred, the extent and degree of the wound suggest that the ischemic insult was prolonged, lasting for several hours. Pediatric clinicians and medical teams should carefully examine the site of insertion of the intravenous catheter, especially in patients receiving parenteral nutrition via a peripheral intravenous catheter with a pressurized infusion pump.

• 한국의학물리학회지:의학물리
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• 제16권1호
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• pp.47-51
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• 2005

전산화단층검사에서 조영제를 자동주입기를 이용해 주입하여 검사하는 경우에 혈관 외 유출된 성인환자를 대상으로 하였다. 환자의 혈관외유출 사고의 조영제 양은 47 ml로 오른쪽 손목 부위가 부종을 동반하였다. 혈관외유출된 손상부위를 axial 스캔하여 MPR (multi-planar reformation), MIP (maximum intensity protection), volume rendering, SSD (shaded-surface display) 기법으로 구성하였다. 이러한 3D 영상은 조영제의 혈관외유출 환자의 예방 및 사후 조치에 적절한 치료계획의 방법으로 기대된다.

• Journal of Korean Neurosurgical Society
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• 제56권5호
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• pp.428-430
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• 2014

Isolated traumatic pseudoaneurysms of the basilar artery are extremely rare but often fatal resulting in a mortality rate as high as 50%. A 51-year-old man presented with craniofacial injury after blunt trauma. A brain computed tomography (CT) scan showed thick basal subarachnoid hemorrhage associated with multiple craniofacial fractures, while CT angiography revealed contrast extravasation at the distal basilar artery with pseudoaneurysm formation. After this primary survey, the condition of the patient suddenly deteriorated. Conventional angiography confirmed the contrast extravasation resulted from pseudoaneurysm formation, which was successfully treated with endovascular coil embolization. Decompressive craniectomy and coma therapy with propofol were also performed. However, the patient died on the 7th hospital day because of the poor initial clinical condition. The current case is the first report of acute pseudoaneurysm rupture arising from the basilar artery within the first day after trauma. Our findings suggest the possibility that pseudoaneurysm rupture should be considered if brain CT shows thick traumatic subarachnoid hemorrhage on the basal cistern with a basal skull fracture.

• Archives of Plastic Surgery
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• 제39권4호
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• pp.412-416
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• 2012

Background Even though the quality of medical and surgical care has improved remarkably over time, iatrogenic injuries that require surgical treatment including injuries caused by cast and elastic bandage pressure, extravasation, and dopamine-induced ischemia still frequently occur. The goal of this study was to estimate the incidence and analyze the distribution of iatrogenic injuries referred to our department. Methods A retrospective clinical review was performed from April 2006 to November 2010. In total, 196 patients (116 females and 80 males) were referred to the plastic surgery department for the treatment of iatrogenic injuries. We analyzed the types and anatomic locations of iatrogenic complications, along with therapeutic results. Results An extravasation injury (65 cases, 37.4%) was the most common iatrogenic complication in our study sample, followed by splint-induced skin ulceration, dopamine-induced necrosis, prefabricated pneumatic walking brace-related wounds and elastic bandage-induced wounds. Among these, prefabricated pneumatic walking brace-related complication incidence increased the most during the 5-year study period. Conclusions The awareness of the very common iatrogenic complications and its causes may allow physicians to reduce their occurrence and allow for earlier detection and referral to a plastic surgeon. We believe this is the first study to analyze iatrogenic complications referred to a plastic surgery department in a hospital unit.