Wound Care After Peripheral Intravenous Extravasation: What Is the Evidence?

Despite a variety of preventative measures and administration of antidotes or other emergency treatment techniques, intravenous (IV) extravasation produces serious wounding and may lead to permanent long-term damage. Extravasation of IV fluids in the subcutaneous space may lead to blistering, necrosis, and damage to the underlying structures. Preterm newborns are at increased risk for extensive wounding owing to fragile vessels, thin epidermis, and limited subcutaneous tissue overriding common sites for placement of peripheral IV cannulas. When prevention techniques fail, immediate recognition of the extravasation, prompt intervention, and initiation of wound care are important nursing interventions to limit tissue damage. There is no consensus regarding immediate treatment or optimal wound care after an IV extravasation in the newborn, and information in the literature is limited to anecdotal or descriptive case reports. This lack of scientific evidence results in regional and unit-based protocols that vary greatly. A review of the current evidence regarding immediate care of IV extravasations and subsequent wound care is presented and highlights the need for scientific research to guide practice.