Looking after my skin following a chemotherapy leak (extravasation)

You have been given this leaflet because you have had an extravasation from your chemotherapy treatment.

What is extravasation?

Extravasation is the leakage (or accidental infiltration) of drugs outside the vein and into the surrounding tissue. This can lead to an immediate painful reaction and in some cases can result in local tissue damage. An extravasation may have been identified by you noticing pain, stinging, swelling, redness or any other skin changes at the site of drug administration, or the nurse administering your chemotherapy may have noticed these changes, along with changes in the flow rate of the drugs.

Why has this occurred?

Extravasation is a rare but known complication of intravenous therapy. Whilst we take all possible precautions against extravasation it is unfortunately impossible to completely prevent it from happening. Everyone’s veins are different and some patients have veins that are more weak and fragile than others. What is important is that the extravasation has been detected and we can commence treatments to minimise any damage that may occur.

What treatment will I need for the extravasation?

The type of treatment that is required will depend on the chemotherapy drug that has leaked. Some drugs only cause a mild irritation whereas some drugs can lead to more tissue damage. We will be able to tell you the type of drug that you have received and will fully inform you of the necessary treatment required. We will provide you with detailed information specific to the treatment you need. This could include simple management with a cold compress, a small procedure to flush out the drugs or the need for additional drugs to be administered. If you need to have additional drugs then we will also provide you with an additional page of information specific to the treatment required for this.

Post extravasation care

Once you have been discharged after an extravasation it is important to monitor the site carefully, daily as follows:

• Has the area changed colour or increased in redness?
• Is the area more painful?
• Has the area of inflammation increased?
• Is pain making it difficult to use your hand or arm?
• Is the area blistering, peeling or flaking?
• Is the area more uncomfortable?

If you notice, or develop, any of the above problems you must contact the hospital immediately via the 24 hour emergency triage number.

• 01223 274224 (oncology patients)
• 01223 274225 (haematology patients)

What can I do to help?

There are a number of things that you can do to aid healing and prevent further tissue damage occurring. These are:

• Do not expose the area to direct sunlight.
• Avoid wearing tight clothing over the affected area.
• Gently exercise the affected hand/arm.
• Do not apply any lotions, creams or ointments unless they have been prescribed by the doctors as part of the treatment for extravasation.
• Protect the area when having a bath/shower to prevent it from getting wet.

Pain relief post extravasation:

• The site of the leakage can remain painful or sore for one or two days after it has happened. You should be able to take mild pain killers (analgesia) for any pain. If you feel this is not adequate then please contact us to discuss stronger pain killers.

Contacts/ Further Information

If you require any further information regarding your extravasation which is not urgent then please contact your consultant team or specialist nurse.

References/ Sources of evidence

• Cambridge University Hospitals ‘Management of suspected extravasation of cytotoxic agents’ protocol (July 2015)
• EONS extravasation Guidelines 2007

Privacy and dignity

Same sex bays and bathrooms are offered in all wards except critical care and theatre recovery areas where the use of high-tech equipment and/or specialist one to one care is required.