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CC BY-NC-ND 4.0 · Indian J Plast Surg 2023; 56(05): 439-442
DOI: 10.1055/s-0043-1774787
Case Series

Management of Epirubicin Extravasation Injuries of the Hand with Debridement and Flap Cover—A Case Series

Rajesh Yellinedi
1   Department of Plastic and Reconstructive Surgery, Basavatarakam Indo American Cancer Hospital and Research Institute (BIACH&RI), Hyderabad, Telangana, India
,
Mukunda Reddy Damalachervu
1   Department of Plastic and Reconstructive Surgery, Basavatarakam Indo American Cancer Hospital and Research Institute (BIACH&RI), Hyderabad, Telangana, India
,
Rambabu Nuvvula
1   Department of Plastic and Reconstructive Surgery, Basavatarakam Indo American Cancer Hospital and Research Institute (BIACH&RI), Hyderabad, Telangana, India
,
Subramanyeshwar Rao Thammineedi
2   Department of Surgical Oncology, Basavatarakam Indo American Cancer Hospital and Research Institute (BIACH&RI), Hyderabad, Telangana, India
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Abstract

Chemotherapy extravasation injury is an iatrogenic injury due to extravasation of the drug from the vessel during infusion therapy. Among various chemotherapeutic drugs, DNA binding vesicants like epirubicin and doxorubicin can lead to extensive tissue necrosis following extravasation. They are commonly used in many chemotherapy regimens including those for carcinoma breast. We present our case series in the management of these wounds with aggressive debridement and regional (pedicled groin)/free flaps (superficial circumflex iliac artery perforator, lateral arm) for cover in five patients. All flaps healed well with patient returning to further treatment in 3 to 4 weeks post-surgery with preservation of hand function. Thus, early recognition of the type of drug that has extravasated is crucial. Regional and free flaps are superior to local flaps because there are no extra incisions and grafts on the limb that has already been injured.

Keywords

chemotherapy extravasation - vesicants - free flap cover


Publication History

Article published online:
10 October 2023

© 2023. Association of Plastic Surgeons of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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