Extravasation of chemotherapeutic agents in subcutaneous tissue at the time of injection sometimes results in severe skin injuries.

From August 1995 to July 1999, we examined the incidence of drug extravasation in patients (pts) who received chemotherapy (Cx) in the out-patient care unit in our institute. We had used stiff metal needles ("Butterfly" catheters) as well as flexible IV catheters until July 1997. However due to high frequency of extravasation, we started using only flexible IV catheters after August 1997. Although the number of pts who received Cx in the out-patient care unit has been increasing every year, the frequency of drug extravasation remarkably decreased since August 1997, as shown in the table.

Four out of 30 pts suffering from drug extravasation in the first period and 5 out of 39 pts in the second period used a flexible IV catheter for a IV device. The number of drug extravasation by using a flexible IV catheter was constant through out the study period.

Other factors such as the skill of IV infusion of the physicians in charge, operating procedure of the unit and the Cx agents used had not changed during this study period. This indicates that the use of flexible IV catheters, rather than needles helps to eliminate a number of cases of extravasation. Although a flexible IV catheter costs three times much than a stiff metal needle, the benefit of reducing the incidence of drug extravasation overweighs the cost.

American Society of Clinical Oncology 2000.