Imperial College London
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Professor Chris Gale

Faculty of Medicine, School of Public Health

Professor of Neonatal Medicine
 
 
 
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Contact

 

+44 (0)20 3315 3519christopher.gale Website

 
 
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Location

 

Academic Neonatal Medicine, H4.4,Chelsea and Westminster HospitalChelsea and Westminster Campus

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Summary

 

Publications

Citation

BibTex format

@article{Little:2020:10.1136/bmjopen-2019-034950,
author = {Little, M and Dupre, S and Wormald, J and Gardiner, M and Gale, C and Jain, A},
doi = {10.1136/bmjopen-2019-034950},
journal = {BMJ Open},
pages = {1--14},
title = {Surgical intervention for paediatric infusion-related extravasation injury: a systematic review},
url = {http://dx.doi.org/10.1136/bmjopen-2019-034950},
volume = {10},
year = {2020}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - ObjectivesThis systematic review aims to assess the quality of literature supporting surgical interventions for paediatric extravasation injury and to determine whether there is sufficient evidence to support invasive techniques in children.MethodsWe performed a systematic review by searching Ovid MEDLINE and EMBASE as well as AMED, CINAHL, Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Database of Systematic Reviews and clinicaltrials.gov from inception to February 2019. Studies other than case reports were eligible for inclusion if the population was younger than 18 years old, there was a surgical intervention aimed at treating extravasation injury and they reported on outcomes. Study quality was graded according to the National Institutes of Health (NIH) study quality assessment tools.Results26 studies involving 728 children were included – one before-and-after study and 25 case series. Extravasation injuries were mainly confined to skin and subcutaneous tissues but severe complications were also encountered, including amputation (one toe and one below elbow). Of the surgical treatments described, the technique of multiple puncture wounds and instillation of saline and/or hyaluronidase was the most commonly used. However, there were no studies in which its effectiveness was tested against another treatment or a control and details of functional and aesthetic outcomes were generally lacking. ConclusionSurgical management is commonly reported in the literature in cases where there is significant soft tissue injury but as there are no comparative studies, it is unclear whether this is optimal. Further observational and experimental research evaluating extravasation injuries, including a centralized extravasation register using a universal grading scheme and core outcome set with adequate follow-up, are required to provide evidence to guide clinician decision-making.
AU  - Little,M
AU  - Dupre,S
AU  - Wormald,J
AU  - Gardiner,M
AU  - Gale,C
AU  - Jain,A
DO  - 10.1136/bmjopen-2019-034950
EP  - 14
PY  - 2020///
SN  - 2044-6055
SP  - 1
TI  - Surgical intervention for paediatric infusion-related extravasation injury: a systematic review
T2  - BMJ Open
UR  - http://dx.doi.org/10.1136/bmjopen-2019-034950
UR  - https://bmjopen.bmj.com/content/10/8/e034950
UR  - http://hdl.handle.net/10044/1/80659
VL  - 10
ER  -
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