Chapter 15: Medicines optimization: ensuring quality and safety
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Definitions
There is variation in the definitions attached to ‘infiltration’ and ‘extravasation’, and the terms are often used interchangeably (Reynolds et al. [300]), which can make reviewing the literature around them problematic. For the purposes of this manual, the following definitions are used.
Infiltration
Infiltration tends to refer to the leakage of non‐vesicant solutions or medications into the surrounding tissues (INS [142]). It generally does not cause tissue necrosis but can result in long‐term injury due to local inflammatory reactions or compression of the surrounding tissues (if a large volume infiltrates), which is known as ‘compartment syndrome’ (Doellman et al. [72], RCN [295], Schulmeister [329]).
Extravasation
Extravasation literally means ‘leaking into the tissues’ but it has been linked with vesicants to describe a process that requires immediate action if local tissue damage is to be prevented (INS [142], Polovich et al. [287], Schulmeister [329]). A vesicant is any solution or medication that causes the formation of blisters with subsequent tissue necrosis and may be DNA‐binding or non‐DNA‐binding (INS [142], Polovich et al. [287]). The most well‐known group of vesicants is cytotoxic chemotherapy agents, but several non‐antineoplastic drugs also have these properties (Buter et al. [36]).
