Management of extensive doxorubicin hydrochloride extravasation injuries.

Forty patients with extensive doxorubicin hydrochloride extravasation injuries are reviewed. These injuries were located in critical anatomic areas such as the palmar aspect of the wrist, dorsum of the hand, and antecubital fossa. Contributing factors were related to local venous pathology, the mode of administration, and the lack of recognition of extravasation. Treatment of these injuries consisted of extensive debridement of all involved tissue and delayed closure by a variety of techniques. The complications and morbidity secondary to doxorubicin hydrochloride extravasation are often more disabling than the patient's primary disease. The degree of disability is related to the site of extravasation, patient's age, and delay before surgical complication. Early recognition and excision and delayed closure yield the most successful results.