Negative-pressure wound therapy and early pedicle flap reconstruction of the chest wall after epirubicin extravasation

J Vasc Access. 2017 May 15;18(3):e27-e29. doi: 10.5301/jva.5000654.

Abstract

Purpose: Accidental extravasation is a serious iatrogenic injury among patients receiving anthracycline-containing chemotherapy. The aim of this work is to present a combination therapy for chest wall reconstruction following epirubicin extravasation.

Methods: Herein, we report a 68-year-old woman with massive soft tissue necrosis of the anterolateral chest wall after epirubicin extravasation from a port implanted in the subclavicular area.

Results: The necrotic tissue was resected, the port was removed, and negative-pressure wound therapy was applied. Three weeks later, a latissimus dorsi pedicle flap was successfully used to cover the defect.

Conclusions: To the best of the authors' knowledge, this is the first report of a strategy comprising the combination of negative-pressure wound therapy and a latissimus pedicle flap for reconstruction of the chest wall after soft tissue necrosis following epirubicin extravasation.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antibiotics, Antineoplastic / administration & dosage
  • Antibiotics, Antineoplastic / adverse effects*
  • Breast Neoplasms / drug therapy*
  • Breast Neoplasms / pathology
  • Catheterization, Central Venous
  • Chemotherapy, Adjuvant
  • Epirubicin / administration & dosage
  • Epirubicin / adverse effects*
  • Extravasation of Diagnostic and Therapeutic Materials / pathology
  • Extravasation of Diagnostic and Therapeutic Materials / therapy*
  • Female
  • Humans
  • Iatrogenic Disease*
  • Infusions, Intravenous
  • Necrosis
  • Negative-Pressure Wound Therapy*
  • Plastic Surgery Procedures*
  • Superficial Back Muscles / transplantation*
  • Surgical Flaps*
  • Thoracic Wall / drug effects
  • Thoracic Wall / pathology
  • Thoracic Wall / surgery*
  • Treatment Outcome
  • Wound Healing

Substances

  • Antibiotics, Antineoplastic
  • Epirubicin