Pearls

• Fluid extravasation injuries that present with a diameter of less than 10 cm and have induration and redness as the primary findings are generally less severe and can often be treated with elevation and ice.

• The incidence of doxorubicin hydrochloride (Adriamycin) extravasation injury is ~3% of those patients receiving the drug. The incidence of extravasation injury from any chemotherapy administration is ~6%.

• The pain associated with a chemotherapy extravasation can be a significant long-term problem. Surgical excision of the affected area often greatly improves the patient's quality of life, even for those individuals who are quite ill already. Excision also diminishes the likelihood or severity of joint stiffness and sympathetic dystrophy.

• Because of their low osmolarity and less direct cytotoxicity, nonionic radiographic contrast agents (such as iohexol) are safer and better tolerated than traditional ionic agents (such as diatrizoate meglumine).

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