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Recommendations for Management of Noncytotoxic Vesicant Extravasations

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To prepare clinicians to treat extravasation of noncytotoxic vesicants with antidotes and thermal compresses, a literature review was performed to identify noncytotoxic vesicants and to create evidence and consensus-based recommendations. The stage of injury and vesicant's mechanism of tissue injury dictate treatment. For a vasopressor extravasation, warm compresses and administration of a vasodilator are recommended. For osmolarity, pH, absorption refractory, and cytotoxic concentration-dependent vesicants, warm compresses and administration of hyaluronidase are recommended. Compared with potentially catastrophic costs of undertreatment, the cost of overtreatment is minimal.

Keywords: compartment syndrome; emergency treatment; extravasation; hyaluronidase; infiltration; irritant; noncytotoxic vesicant antidote; phentolamine; soft tissue injury; terbutaline; tissue or skin necrosis; warm or cold compress

Document Type: Research Article

Publication date: November 1, 2020

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