Extravasation is the leakage of a fluid out of its contained space into the surrounding area, especially blood or blood cells from vessels. In the case of inflammation, it refers to the movement of white blood cells through the capillary wall, into the surrounding tissues. This is known as (leukocyte extravasation, also called diapedesis). In the case of cancermetastasis, it refers to cancer cells exiting the capillaries and entering other tissues, where secondary tumors may form. The term is commonly used in a medical context.
Extravasation of irrigation fluid is the unintended migration of irrigation fluid (e.g. saline) introduced into a human body. This may occur in a number of types of endoscopic surgery, such as minimally invasive orthopedic surgery, i.e. arthroscopy, TURP (trans-urethral resection of the prostate) and TCRE (trans-cervical resection of the endometrium).
In arthroscopy, fluid under pressure is used to inflate and distend a joint and make a working surgical space. Arthroscopy is typically performed on shoulder and knee joints; however, hip arthroscopy is becoming more popular. Arthroscopy is done by making surgical portals or puncture wounds into the joint. A surgical instrument called an arthroscope is used to introduce irrigation fluid under pressure to distend the joint. The arthroscope includes a small (typically 4 mm in diameter) optic scope rod to view the joint. Other portals or puncture wounds are made to introduce surgical instruments to perform cutting or repair procedures.
If the joint is surrounded by soft tissue, as in the shoulder and hip, fluid under pressure may leak out of the joint space through the surgical portals and collect in the patient's soft tissue. A typical arthroscopy can result in 1–3 liters of irrigation fluid being absorbed into the patient's interstitial tissue. This buildup of irrigation fluid in the soft tissue may cause edema. This swelling can interfere with the arthroscopic procedure by collapsing the surgical space, or migrating into the patient's neck and causing airway blockage. In hip arthroscopy, a feared complication is abdominal flooding where the irrigation fluid leaks from the hip joint capsule and drains into the abdominal cavity. Risk factors for fluid extravasation include procedure length (> 90–120 min), obesity, and age (> 45–50) with accompanying lack of muscle tone.
Shoulder arthroscopy is typically limited to about 90–120 minutes before the swelling from fluid extravasation interferes with the procedure, and presents a potential risk to the patient. Typically, fluid extravasation is managed by controlling fluid pressure, or hastening the procedure.
Extravasation of infusatesEdit
Extravasation may also refer to the leakage of infused substances from the vasculature into the subcutaneous tissue. The leakage of high-osmolarity solutions or chemotherapy agents can result in significant tissue destruction and significant complications.
Complications in Orthopaedics: Shoulder Arthroscopy, chapter "Severe Edema During Shoulder Arthroscopy" pp 9–16, Xavier A. Duralde, MD, editor.
Immediate postoperative fluid retention and weight gain after shoulder arthroscopy. LoIK, Burkhart SS. Arthroscopy. 2005 May; 21(5):605–610.
Life Threatening Airway Edema Resulting From Prolonged Shoulder Arthroscopy, Steven L. Orebaugh, M.D. Anesthesiology, V 99, No. 6, December 2003.
Severe Airway Obstruction During Arthroscopic Shoulder Surgery, Stephan Blumenthal, M.D., Marco Nadig, M.D., Christian Gerber, M.D., Alain Borgeat, M.D. Anesthesiology, V 99, No. 6, December 2003.
Complete Airway Obstruction During Shoulder Arthroscopy, Hynson, J.M., Tung, A., Guevara, J.E., et al. Anesthesiology Analg, 76:875–878, 1993.
Complications of hip arthroscopy, Sampson, T.G. Clin Sports Med. 20(4):831–835, October 2001.
External linksEdit
published by the American Association of Orthopedic Surgeons (AAOS)
British National Health Service page on complications from extravasation of infusates.
Cannuflow Research archive on extravasation in shoulder arthroscopy
Cannulae with Outflow Reduces Fluid Gain in Shoulder Arthroscopy Hasan M. Syed, Seth B. Gillham, Christopher M. Jobe, Wesley P. Phipatanakul and Montri D. Wongworawat
October 10, 2023
extravasation, this, article, includes, list, references, related, reading, external, links, sources, remain, unclear, because, lacks, inline, citations, please, help, improve, this, article, introducing, more, precise, citations, march, 2010, learn, when, rem. This article includes a list of references related reading or external links but its sources remain unclear because it lacks inline citations Please help to improve this article by introducing more precise citations March 2010 Learn how and when to remove this template message Extravasation is the leakage of a fluid out of its contained space into the surrounding area especially blood or blood cells from vessels In the case of inflammation it refers to the movement of white blood cells through the capillary wall into the surrounding tissues This is known as leukocyte extravasation also called diapedesis In the case of cancer metastasis it refers to cancer cells exiting the capillaries and entering other tissues where secondary tumors may form The term is commonly used in a medical context More specifically extravasation can refer to Extravasation intravenous Extravasation of infusates Extravasation of irrigation fluid Extravasation of urine Leukocyte extravasation Angiopellosis non leukocyte cell extravastion Extravasation of irrigation fluid EditExtravasation of irrigation fluid is the unintended migration of irrigation fluid e g saline introduced into a human body This may occur in a number of types of endoscopic surgery such as minimally invasive orthopedic surgery i e arthroscopy TURP trans urethral resection of the prostate and TCRE trans cervical resection of the endometrium In arthroscopy fluid under pressure is used to inflate and distend a joint and make a working surgical space Arthroscopy is typically performed on shoulder and knee joints however hip arthroscopy is becoming more popular Arthroscopy is done by making surgical portals or puncture wounds into the joint A surgical instrument called an arthroscope is used to introduce irrigation fluid under pressure to distend the joint The arthroscope includes a small typically 4 mm in diameter optic scope rod to view the joint Other portals or puncture wounds are made to introduce surgical instruments to perform cutting or repair procedures If the joint is surrounded by soft tissue as in the shoulder and hip fluid under pressure may leak out of the joint space through the surgical portals and collect in the patient s soft tissue A typical arthroscopy can result in 1 3 liters of irrigation fluid being absorbed into the patient s interstitial tissue This buildup of irrigation fluid in the soft tissue may cause edema This swelling can interfere with the arthroscopic procedure by collapsing the surgical space or migrating into the patient s neck and causing airway blockage In hip arthroscopy a feared complication is abdominal flooding where the irrigation fluid leaks from the hip joint capsule and drains into the abdominal cavity Risk factors for fluid extravasation include procedure length gt 90 120 min obesity and age gt 45 50 with accompanying lack of muscle tone Shoulder arthroscopy is typically limited to about 90 120 minutes before the swelling from fluid extravasation interferes with the procedure and presents a potential risk to the patient Typically fluid extravasation is managed by controlling fluid pressure or hastening the procedure Extravasation of infusates EditExtravasation may also refer to the leakage of infused substances from the vasculature into the subcutaneous tissue The leakage of high osmolarity solutions or chemotherapy agents can result in significant tissue destruction and significant complications See also EditArthroscopy IntravasationReferences EditComplications in Orthopaedics Shoulder Arthroscopy chapter Severe Edema During Shoulder Arthroscopy pp 9 16 Xavier A Duralde MD editor Immediate postoperative fluid retention and weight gain after shoulder arthroscopy LoIK Burkhart SS Arthroscopy 2005 May 21 5 605 610 Life Threatening Airway Edema Resulting From Prolonged Shoulder Arthroscopy Steven L Orebaugh M D Anesthesiology V 99 No 6 December 2003 Severe Airway Obstruction During Arthroscopic Shoulder Surgery Stephan Blumenthal M D Marco Nadig M D Christian Gerber M D Alain Borgeat M D Anesthesiology V 99 No 6 December 2003 Complete Airway Obstruction During Shoulder Arthroscopy Hynson J M Tung A Guevara J E et al Anesthesiology Analg 76 875 878 1993 Complications of hip arthroscopy Sampson T G Clin Sports Med 20 4 831 835 October 2001 External links EditMonograph on Complications in Shoulder Arthroscopy published by the American Association of Orthopedic Surgeons AAOS British National Health Service page on complications from extravasation of infusates Cannuflow Research archive on extravasation in shoulder arthroscopy Cannulae with Outflow Reduces Fluid Gain in Shoulder Arthroscopy Hasan M Syed Seth B Gillham Christopher M Jobe Wesley P Phipatanakul and Montri D Wongworawat Retrieved from https en wikipedia org w index php title Extravasation amp oldid 1145332298, wikipedia, wiki, book, books, library,
