Soft-tissue reconstruction following extravasation of chemotherapeutic agents.

The incidence of chemotherapeutic extravasation injuries ranges from 0.5% to 6%. Chronicity and an indolent course are prominent characteristics of such wounds, as are severe pain and ulceration with no tendency to spontaneous healing. Prevention is the best treatment. Aggressive surgical debridement is recommended for patients with persistent pain or ulceration. Whirlpool therapy, wet-to-dry dressing changes, and a vigorous physical therapy program are all helpful. Soft-tissue coverage can be obtained by skin grafting, delayed flaps, various local muscle or fasciocutaneous flaps, or by free tissue transfer.