Cancer chemotherapy agent-induced perivenous extravasation injuries

Chemotherapy occupies a well defined role in tumour management and has transformed the prognosis of many haematological neoplasms and solid tumours. Unfortunately, the large majority of chemotherapeutic agents currently in use are toxic to tissues in general and produce tissue necrosis on perivenous extravasation. The sequelae add considerably to the morbidity of an already seriously ill patient, prolonging hospitalization and often necessitating temporary cessation of therapy. The potential for litigation is high, as these are mostly avoidable complications.1 Furthermore, this complication is unacceptable if the patient is receiving adjuvant therapy, often as part of a clinical trial. The need for early surgical attention to these injuries is not widely appreciated, and delay in obtaining surgical advice is common.2 Prolonged morbidity results from the consequent delay in definitive management. This review aims to discuss the pathogenesis, prevention and management of these injuries and attempts to provide useful guide-lines in clinical practice.