Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Apr;14(2):430-434.
doi: 10.1111/iwj.12628. Epub 2016 Jul 19.

Computed tomography contrast media extravasation: treatment algorithm and immediate treatment by squeezing with multiple slit incisions

Sue Min Kim  1 , Kyung Hoon Cook  1 , Il Jae Lee  1 , Dong Ha Park  1 , Myong Chul Park  1
Affiliations

Computed tomography contrast media extravasation: treatment algorithm and immediate treatment by squeezing with multiple slit incisions

Sue Min Kim et al. Int Wound J. 2017 Apr.

Abstract

In our hospital, an adverse event reporting system was initiated that alerts the plastic surgery department immediately after suspecting contrast media extravasation injury. This system is particularly important for a large volume of extravasation during power injector use. Between March 2011 and May 2015, a retrospective chart review was performed on all patients experiencing contrast media extravasation while being treated at our hospital. Immediate treatment by squeezing with multiple slit incisions was conducted for a portion of these patients. Eighty cases of extravasation were reported from approximately 218 000 computed tomography scans. The expected extravasation volume was larger than 50 ml, or severe pressure was felt on the affected limb in 23 patients. They were treated with multiple slit incisions followed by squeezing. Oedema of the affected limb disappeared after 1-2 hours after treatment, and the skin incisions healed within a week. We propose a set of guidelines for the initial management of contrast media extravasation injuries for a timely intervention. For large-volume extravasation cases, immediate management with multiple slit incisions is safe and effective in reducing the swelling quickly, preventing patient discomfort and decreasing skin and soft tissue problems.

Keywords: Complications; Contrast Media; Extravasation; Tomography.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Multiple slit incision procedure. (A) Drainage of extravasated contrast media (CM) with multiple slit incisions. (B) Multiple slit incisions, 2–3 mm in size, were made near the catheter insertion site with a number‐11 blade, carefully avoiding visible vessels. The affected limb was then squeezed toward the slit incisions, with squeezing continued until no more CM drained out, and the patient felt relieved of the pressure. (C) Oedema of the affected limb disappeared within 1–2 hours of treatment.
Figure 2
Figure 2
The incidence of the contrast media extravasation by the age.
Figure 3
Figure 3
Algorithm summarising the guidelines of the initial management of contrast media extravasation injuries during computed tomography scanning.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Ghanem AM, Mansour A, Exton R, Powell J, Mashhadi S, Bulstrode N, Smith G. Childhood extravasation injuries: improved outcome following the introduction of hospital‐wide guidelines. J Plast Reconstr Aesthet Surg 2015;68:505–18. - PubMed
    1. Hanrahan K. Hyaluronidase for treatment of intravenous extravasations: implementation of an evidence‐based guideline in a pediatric population. J Spec Pediatr Nurs 2013;18:253–62. - PubMed
    1. Brown AS, Hoelzer DJ, Piercy SA. Skin necrosis from extravasation of intravenous fluids in children. Plast Reconstr Surg 1979;64:145–50. - PubMed
    1. Camp‐Sorrell D. Developing extravasation protocols and monitoring outcomes. J Intraven Nurs 1998;21:232–9. - PubMed
    1. Napoli P, Corradino B, Badalamenti G, Tripoli M, Vieni S, Furfaro MF, Cordova A, Moschella F. Surgical treatment of extravasation injuries. J Surg Oncol 2005;91:264–8. discussion 8–9. - PubMed