Extravasation injuries in the upper extremity.

Fourteen patients with intravenous extravasations of chemotherapeutic medications, radiographic contrast agents, vasopressors, fluorescein, or albumin/potassium phosphate were evaluated with regard to function and cosmesis. The average follow-up period was 8.4 months (range, one-24 months). Five patients initially were managed conservatively and, after demarcation of the necrotic area, had surgical procedures for skin coverage. Four of these patients had poor functional and cosmetic results. The remaining patient had an excellent final result. Because of the generally poor results observed in the aforementioned patients, a program of early recognition and surgical intervention in selected extravasation cases was instituted. Following this change, eight of nine patients had good or excellent results. Early surgical involvement in the evaluation of extravasations, with and early surgical drainage and irrigation in selected severe cases, appears to improve the outcome of these iatrogenic injuries.