Versajet hydrosurgery system in the debridement of skin necrosis after Ca gluconate extravasation: report of 9 infantile cases

Objective: The aim of the study was to evaluate the results of debridement with Versajet hydrosurgery system in patients with skin necrosis after ca gluconate extravasation. Methods: We evaluated nine infants (mean age: 26 days; range: 1 day to 3 months) with calcium gluconate extravasation injury. Site of injury was the foot in 3 cases, the hand and wrist in 5 and the scalp in one. In all patients the skin necrosis was debrided with Versajet hydrosurgery system under general anesthesia without damaging the dermis layer. Results: Following debridement all wounds healed spontaneously by re–epithelization and the mean time of full epithelization was fourteen days. No patient required a second debridement. At a minimum follow–up of 1 year minimal scar formation was noted and there was no hypertrophic scar. Conclusion: Versajet hydrosurgery system appears to be effective in the debridement of skin necrosis due to ca gluconate extravasation in pediatric population.

___

1. Murphy PM, Gault DT. Treatment of extravasation injury. Anaesthesia 1990;45:600.

2. Hannon MG, Lee SK. Extravasation injuries. J Hand Surg Am 2011;36:2060-6.

3. Namazi H. Extravasation injuries: a practice pearl. [Letter to the Editor] J Hand Surg Am 2012;37:861.

4. Heitmann C, Durmus C, Ingianni G. Surgical management after doxorubicin and epirubicin extravasation. J Hand Surg Br 1998;23:666-8.

5. Wong FC, Kim, EE, Sparks, R, Wong W-H, Yang DJ, Podoloff DA. Three sphere dosimetry models (0.4 cc, 2cc and 10cc) of 12 commonly available radionuclides for locoregional therapy or extravasation. J Nucl Med 2001;42(5 Suppl):28.

6. Dionyssiou D, Chantes A, Gravvanis A, Demiri E. The wash-out technique in the management of delayed presentations of extravasation injuries. J Hand Surg Eur Vol 2011;36:66-9.

7. Domínguez-Fernández I, Goíriz R, Pérez-Gala S, Fraga J, Fernández-Herrera J. Calcinosis cutis following extravasation of calcium salts. J Eur Acad Dermatol Venereol 2008;22:505-6.

8. Cedidi C, Hierner R, Berger A. Plastic surgical management in tissue extravasation of cytotoxic agents in the upper extremity. Eur J Med Res 2001;6:309-14.

9. Fraccalvieri M, Serra R, Ruka E, Zingarelli E, Antoniotti U, Robbiano F, et al. Surgical debridement with VERSAJET: an analysis of bacteria load of the wound bed preand post-treatment and skin graft taken. A preliminary pilot study. Int Wound J 2011;8:155-61.

10. Soong M, Schmidt S. Acute contaminated open forearm fractures treated with VersaJet Hydrosurgical Débridement. J Orthop Trauma 2010;24:66-8.

11. Dillon CK, Lloyd MS, Dzeiwulski P. Accurate debridement of toxic epidermal necrolysis using Versajet. Burns 2010;36:581-4.

12. Kimble RM, Mott J, Joethy J. Versajet hydrosurgery system for the debridement of paediatric burns. Burns 2008;34:297-9.

13. Jeffery SL. Versajet hydrosurgery in burns wound debridement: a preliminary experience by Gravante G, Esposito G, Delogu D, Montone A. Burns 33;207:401-2. Burns 2007;33:800.

14. Millam DA. Managing complications of i.v. therapy (continuing education credit). Nursing 1988;18:34-43.

15. Lin CY, Hsieh KC, Yeh MC, Sheen-Chen SM, Chou FF. Skin necrosis after intravenous calcium chloride administration as a complication of parathyroidectomy for secondary hyperparathyroidism: report of four cases. Surg Today 2007;37:778-81.

16. Lehnhardt M, Vu P, Kuhnen C, Steinstraesser L, Muehlberger T, Druecke D, et al. Serious complications of injections-retrospective analysis of incidences, complicationmanagement, prophylaxis and economic aspects. [Article in German] Zentralbl Chir 2005;130:162-9. [Abstract]

17. Schummer W, Schummer C, Müller A, Karzai W. Extravasation: a rare complication of central venous cannulation? Case report of an imminent erosion of the common carotid artery. [Article in German] Anaesthesist 2003;52:711- 7. [Abstract]

18. Kumar RJ, Pegg SP, Kimble RM. Management of extravasation injuries. ANZ J Surg 2001;71:285-9.
Acta Orthopaedica et Traumatologica Turcica-Cover
  • ISSN: 1017-995X
  • Başlangıç: 2015
  • Yayıncı: Türk Ortopedi ve Travmatoloji Derneği
Sayıdaki Diğer Makaleler

Middle-term therapeutic effect of the sacroiliac joint blockade in patients with lumbosacral fusion-related sacroiliac pain

NİHAL BÜKER, Semih AKKAYA, OĞUZHAN GÖKALP, Ali KİTİŞ, RAZİYE ŞAVKIN, A. Esat KITER

Orhan Abdi (Kurtaran) (1877-1948) and chapters related to orthopedic surgery in Ameliyât-ı Cerrâhiye [Operative Surgery] in its centennial ( HISTORICAL OVERVIEW )

A. Erdem BAGATUR, Hamit TOPRAK

Versajet hydrosurgery system in the debridement of skin necrosis after Ca gluconate extravasation: report of 9 infantile cases

NAZAN ŞAHİN SİVRİOĞLU, Saime İRKÖREN

Effects of Aircast brace and elastic bandage on physical performance of athletes after ankle injuries

SEVTAP GÜNAY UÇURUM, AYNUR AYŞE KARADUMAN, Burcu Bahar ÖZTÜRK

Effects of two different solutions used in pin site care on the development of infection

RAHŞAN ÇAM, Fatma KORKMAZ DEMİR, Şevki ŞAVK ÖNER

A case of osteoid osteoma in the distal radius epiphysis with atypical onset

Alper DEVECİ, Ahmet FIRAT, MURAT BOZKURT, Sema HÜCÜMENOĞLU

An unusual complication following total hip arthroplasty: median circumflex femoral artery pseudoaneurysm

Serhat MUTLU, OLCAY GÜLER, Adem UÇAR, Mahir MAHİROĞULLARI

Use of femoral nail with spiral blade in subtrochanteric fractures

Masood UMER, Haroon RASHID, Idrees SHAH, Irfan QADIR

A comparison of epidural analgesia and local infiltration analgesia methods in pain control following total knee arthroplasty

Eylem BEDİR BİNİCİ, Tuhan KURTULMUŞ, Selma BAŞYİĞİT, Uğur BAKIR, Necdet SAĞLAM, Gürsel SAKA

Differences in body fat mass, muscular endurance, coordination and proprioception in woman with and without knee pain: a cross-sectional study

DERYA ÖZER KAYA, İREM DÜZGÜN, Gül BALTACI