Epirubicin
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Epirubicin Extensive necrosis of the skin and subcutaneous tissue secondary to drug extravasation: case report
A 68-year-old woman developed extensive necrosis of the skin and subcutaneous tissue of the dorsal aspect of the right forearm and dorsum of the hand secondary to epirubicin extravasation while being treated for breast cancer [duration of treatment to reaction onsets not stated]. The woman, who had a history of breast cancer, had undergone left radical mastectomy and axillary dissection previously. She had been receiving epirubicin [dosage and route not stated] for breast cancer. She presented with an extensive necrosis of the skin and subcutaneous tissue of the dorsal aspect of the right forearm and dorsum of the hand secondary to extravasation of epirubicin and was hospitalised. However, it occurred 3 weeks prior in another hospital, where it was treated with topical dressings of sodium alginate. At presentation, the wound area was coarsely demarcated; however, it was covered with fibrin and non-vital tissues. The woman’s treatment was started with surgical radical debridement of the wound followed by negative pressure wound therapy positioning (NPWT). In order to assess the viability of the wound bed, a dressing change was carried out 48h later, and wound bed appeared well vascularised with no signs of infection. Integra double layer was applied on the tissue defect and sutured with metal clips. Residual fluid drainage was achieved by making stab incisions on the dermal substitute. Further V.A.C therapy at -75mm Hg was used to perform wound coverage. Three weeks later, the external silicon layer was removed and wound was covered with split-thickness skin grafts. Further, V.A.C therapy was applied to the grafted area. Skin graft take was between 90–95% with complete wound heal in 15 days, and 6 weeks following the first surgical debridement, she resumed her chemotherapy. Faenza M, et al. Combined approach with negative pressure wound therapy and dermal substitute for extravasation injury: Why can’t they be friends? JPRAS Open 25: 62-67, Sep 2020. Available from: URL: http://doi.org/10.1016/j.jpra.2020.06.004 803497440
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Reactions 22 Aug 2020 No. 1818
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