Clinical course and management of accidental adriamycin extravasation

Adriamycin infiltration into subcutaneous tissues during intravenous administration results in an intense inflammatory response, which may progress to full‐thickness skin loss and irreversible damage to underlying tendons and neuro‐vascular structures. An analysis of 10 patients seen with Adriamycin infiltration indicated that healing of ulcerated lesions is often prolonged and associated with significant morbidity. Seven patients suffered skin ulcerations and three had severe functional impairment due to joint contractures. Adriamycin should not be infused near joints if possible. Surgical excision of ulcers is advocated if healing is prolonged. Proper local therapy, as well as early attention to proper splinting and physical therapy, can help reduce ultimate functional disability.