Managing chemotherapy extravasation in totally implantable central venous access: Use of subcutaneous wash-out technique. Issue 5 (September 2020)

• Record Type: Journal Article
• Authors: Taibi, Abdelkader; Bardet M, Sylvia; Durand Fontanier, Sylvaine; Deluche, Elise; Fredon, Fabien; Christou, Niki; Usseglio, Julie; Mathonnet, Muriel
• Is Part Of: Journal of vascular access. Volume 21:Issue 5(2020)
• Page Start: 723
• Page End: 731
• Publication Date: 2020-09
• Subjects: Pinch-off syndrome -- central venous access -- wash-out -- extravasation -- chemotherapy; Arterial catheterization -- Periodicals; Intravenous catheterization -- Periodicals; 612.13
• DOI: 10.1177/1129729820905174
• Languages: English
• ISSNs: 1129-7298

Abstract

Background: Totally implanted venous access is widely used in chemotherapy administration. With over 1 million intravenous chemotherapy infusions given worldwide each day, complications are frequent. Accidental cases of extravasation in the presence of a catheter are rare yet very serious and may require discontinuation of chemotherapy. The aim of this study was to evaluate the feasibility and efficacy of the subcutaneous wash-out technique for chemotherapy extravasation treatment. Methods: We retrospectively reviewed the medical charts of patients who had received chemotherapy and sustained extravasation in our hospital between October 2013 and October 2016. Subcutaneous wash-out treatments were carried out exclusively, without the application of antidotes or the use of specific antidotes. Results: We documented seven cases of chemotherapy extravasation. Two cases were treated with antidotes and suffered necrosis in the following weeks. The five patients treated using subcutaneous wash-out had no necrosis and had a steady decrease in the inflammatory reaction of the cutaneous and subcutaneous soft tissues. For these five patients, chemotherapy was restarted within 1 month following extravasation. Conclusion: This study would argue for the feasibility and effectiveness of subcutaneous wash-out in the treatment of chemotherapy extravasations.