Treatment of cutaneous injuries of neonates induced by drug extravasation with hyaluronidase and hirudoid

Abstract

Objective: To analyze the effects of hyaluronidase and hirudoid treatment on drug extravasation in neonates.

Methods: The medical records of 13 neonates with drug extravasation treated with hyaluronidase and hirudoid between August 1(st), 2010 and May 1(st), 2012 were analyzed retrospectively. The treatment procedure for drug extravasation adhered to the protocol in neonatal department. The information including age, sex, weight, diagnosis, size of affected area, site of extravasation and treatment was collected. Findings : The extravasation injuries alleviated and the symptoms improved after treatment, no adverse drug effects were reported with use of hyaluronidase and hirudoid.

Conclusion: The treatment appeared to be beneficial in the management of extravasations of various medications in neonates and may be useful in reducing the severity of cutaneous toxicosis. However, further studies with large samples are still needed to assess the effectiveness and safety of hyaluronidase and hirudoid.

Keywords: Drug Extravasation; Hirudoid; Hyaluronidase; Neonate; Treatment.

Fig. 1

Amount of hyaluronidase and site of injection.

Fig. 2

Use of hyaluronidase together with hirudoid decreased the severity of extravasation injuries. (A) Skin swelling and erythema a few hours after total parental nutrition fluid extravasation in a newborn aged 11 days. (B) Appearance 2 days after early treatment (<8 h). (C) Skin swelling and erythema completely disappeared in the 8th day after treatment, necrosis has been avoided.

Fig. 3

Time of treatment initiation influences the effect. (A) Appearance of extravasation of calcium chloride on the scalp, treatment was given more than 14h after the extravasation. (B) Skin scar was developed 3 days after the event happened. (C) Calcinosis was developed 3 weeks after discharge from hospital.