The Comparative Study of Treatment Method on Adriamycin-Induced Extravasation Injury.

Moon, In Sun; Lee, Chang Ho; Kwon, Yong Seok; Lee, Keun Cheol; Kim, Seok Kwun

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Original Article

Journal of the Korean Society of Plastic and Reconstructive Surgeons 2009;36(3):269-276.
Published online May 1, 2009.

The Comparative Study of Treatment Method on Adriamycin-Induced Extravasation Injury.

In Sun Moon, Chang Ho Lee, Yong Seok Kwon, Keun Cheol Lee, Seok Kwun Kim

Department of Plastic & Reconstructive Surgery, College of Medicine, Dong-A University, Busan, Korea. sgkim1@dau.ac.kr

Abstract

PURPOSE
Local skin necrosis after extravasation of adriamycin, a widely used chemotherapeutic agent, is a common problem in cancer patients. The extravasation of chemotherapeutic agents yields severe inflammatory responses, crust formation, skin necrosis, and ulceration. Even though several treatment options have been proposed for extravasation injury, there is still controversy regarding the management of such lesions. Thus the aim of this study was to compare the efficacy of saline injection (Group 1), hydrocortisone injection (Group 2), propranolol injection (Group 3) and early surgical excision as a treatment (Group 4) in a rat extravasation model. METHODS: The authors planned forty mature male Sprague-Dawley rats were divided into 4 groups and each group contained 10 rats. Administration of adriamycin (1.0 mg/mL) 1.5 mL by subcutaneous injection on the dorsal side of the rats was followed by protocol. The treatment options were applied 2 hours after adriamycin injection. At the end of the 5th day, the presence and size of ulcers at the injection site were checked. Three weeks after injection, a histopathologic examination was performed for each treatment and control group. T-tests were used to analyze the differences between the measurements.
RESULTS
Propranolol significantly improved tissue recovery compared with control group and other groups. These data suggest that there is little role for saline and hydrocortisone in the treatment of adriamycin extravasation injury.
CONCLUSION
In this study, we compared some treatment methods in adriamycin extravasation model. The findings support the propranolol injection may prevent extravasation injury. However this study was performed in the laboratory using rats, and the results could be different in clinical application. Further investigations and more clinical application are needed.

Keywords: Adriamycin; Extravasation injury; Hydrocortison; Propranolol; Excision

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