The "tissued" cannula

Everyone is familiar with the adverse effects of extravasation of cytotoxic agents into peripheral tissues. The outcome can be significant tissue loss, vessel and nerve damage, requiring plastic surgical reconstruction. Non-cytotoxic agents are equally able to cause significant tissue damage when extravasation occurs.

Guidelines are available for the management of accidental extravasation, and plastic surgical teams are always able to provide advice when needed. However, it is frequently overlooked, and as the tissue damage can be slow to develop, the patient may be discharged home before the full extent of the damage is realised.

As with many clinical errors, clinicians should be alert to the potential risk of an extravasation incident and when this does occur document the details of the incident and provide the patient with an explanation of the potential outcome and opportunities to return for treatment should this be required. This will reduce the extent of the damage and avoid patient confrontation and negligence claims when trust breaks down between medical teams and the patient.