J Korean Med Sci.  2007 Jun;22(3):588-594. 10.3346/jkms.2007.22.3.588.

Successful Combined Treatment with Total Parenteral Nutrition Fluid Extravasation Injuries in Preterm Infants

• Cho KY
• Lee SJ
• Burm JS
• Park EA

• KMID: 1778379
• DOI: http://doi.org/10.3346/jkms.2007.22.3.588

Abstract

Extravasation injuries in the neonatal intensive care unit are not rare during parenteral hyperalimentation. There have been many different methods of management. We report five premature infants with wounds of hyperalimentation fluid extravasation managed by the antibacterial ointment (Terramycin ophthalmic ointment(TM)) and sesame oil and a antiinflammatory herbal mixture (MEBO(TM)). The mean gestational age of patients was 31(+2) weeks (range, 28(+4) to 35(+6) weeks), and the mean weight at extravasation was 1,930 g (range, 1,140 to 2,680 g). Extravasation occurred within the mean of 32 days (range, 17 to 50 days). The method of dressing was application of a thick layer of this mixture covered by vaseline and wet gauze renewed at an interval of 8-12 hr after irrigating the wounds thoroughly with normal saline. The mean duration of dressing was 30 days (range, 20-50 days). The wounds had healed completely leaving a small size of contracture without functional abnormality. We conclude that this therapy may be considered for an alternative treatment and warrants clinical trials for the confirmation of the local management of extravasation injury.

Keyword

Extravasation; Hyperalimentation Fluid; Preterm Infants; Antibacterial Ointment; Sesame Oil; Antiinflammatory Herbal Mixture

MeSH Terms

Administration, Topical
Anti-Bacterial Agents/*administration & dosage
Extravasation of Diagnostic and Therapeutic Materials/*therapy
Humans
Infant
Infant, Newborn
Infant, Premature
Infant, Premature, Diseases/*therapy
Ointments
Oxytetracycline/*administration & dosage
Parenteral Nutrition
Phytotherapy/methods
Treatment Outcome
Veins/*injuries
Wound Healing

Figure

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  Fig. 1 (A) Extravasation with 12.5% total parenteral nutrition and 10% intralipid on the dorsum of the right foot. (B) Four weeks after treatment.

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  Fig. 2 (A) Extravasation with pack red blood cells on the dorsum of the right hand. (B) Eighteen days after treatment. (C) Five weeks after treatment.

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  Fig. 3 (A) Extravasation with 12.5% total parenteral nutrition on the left forearm. (B) Two months after treatment.

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  Fig. 4 (A) Extravasation with 12.5% total parenteral nutrition on the dorsum of left foot. (B) Eighteen days after treatment. (C) Fifty days after treatment. (D) Eighteen months after treatment.

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  Fig. 5 (A) Extravasation with 12.5% total parenteral nutrition and 10% intralipid on the lateral side of the right foot. (B) Two years after treatment.

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  Fig. 6 (A) A few days after extravasation with 12.5% total parenteral nutrition and 10% intralipid on the lateral side of the left foot. (B) Twenty months after treatment.

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