The consequences of delayed treatment in doxorubicin extravasation

Abstract

Doxorubicin (Adriamycin) is an anthracycline chemotherapy agent used for the treatment of several cancers including haematological malignancies. Extravasation is a well-recognized and possibly serious complication of administered intravenous therapies, especially in chemotherapeutic agents. Drug extravasation into the surrounding tissue has been estimated to occur in 0.1–6% of patients that receive chemotherapy. Signs of the injury can be subtle, and in case of delayed detection (> 6 h) and treatment, doxorubicin extravasation can result in substantial tissue damage with significant loss of function depending on the location of injury. Other consequences include pain, physical defect, psychological distress, cost of hospitalization and treatment and more extensive damage to skin and underlying tissue. In this article, we will discuss a case of delayed treatment of doxorubicin extravasation from a Venflon venous line at the dorsum of the hand with severe tissue necrosis as a result. Successful surgical reconstruction of the resulting substantial tissue damage using a SCIAP flap 25 days following the extravasation is described. Level of evidence: Level V, risk study.