Nafcillin extravasation injury. Use of hyaluronidase as an antidote
K. E. Zenk, C. I. Dungy and G. R. Greene
Subcutaneous extravasation of parenteral nafcillin sodium can cause
deep-tissue necrosis, sometimes necessitating multiple debridements and
skin grafting. We report two cases in which nafcillin-induced tissue injury
was successfully prevented by prompt clysis of hyaluronidase to the site of
infiltration; these patients are compared with an infant in whom
hyaluronidase was not used and in whom full-thickness skin loss resulted.
Hyaluronidase is an enzyme that reduces or prevents tissue injury by
causing the rapid diffusion of extravasated fluids through tissues by
temporarily destroying tissue cement, thus increasing absorptive surface
and the resultant rate of absorption. We have found that hyaluronidase,
when used promptly after an extravasation has occurred, is effective in
markedly reducing the amount of local tissue damage and destruction caused
by the infiltration of nafcillin.
