Vesicant chemotherapy - the management of extravasation

Vesicant chemotherapy agents can cause varying degrees of tissue necrosis when they extravasate from the vein or are inadvertently administered into the tissue. Deoxyribonucleic acid (DNA) binding vesicants, such as anthracyclines, bind to the DNA of healthy tissue. Left untreated, these injuries progress over time and often require surgical intervention. Evidence-based treatment is topical cooling and administration of Savene (dexrazoxane). Non-DNA binding agents, such as plant alkaloids, usually remain localised and are metabolised in the tissue. Local heat application is recommended. To help prevent or treat extravasation injuries, oncology nurses should be aware of current guidelines for vesicant chemotherapy extravasation management, and be prepared to implement new antidotes and treatments in their clinical practice.