Chemotherapy Extravasation Management with DMSO

Evidence-Based Treatment Options

The European Society for Medical Oncology recommends DMSO as a topical treatment option for extravasations occurring during anthracyclines, mitomycin C, or platinum salts infusion, with Level III, B evidence 1, 2
The application protocol for DMSO in chemotherapy extravasation management involves applying 99% DMSO at four drops per 10 cm² of skin surface over the affected area, leaving it to air dry without dressing, and repeating every 8 hours for 1 week 1, 2, 3
DMSO should be administered within the first 10 minutes after extravasation for optimal effect, and clinical evidence shows that in 84% of cases, DMSO was applied within this timeframe, resulting in only 1 patient developing ulceration out of 144 patients treated 4
The use of DMSO in chemotherapy extravasation management is supported by clinical evidence, which demonstrates its effectiveness in reducing the risk of ulceration and promoting healing 4

The use of DMSO at high concentrations can cause local erythema, which may affect proper evaluation of tissue damage, and therefore should be used with caution 4
When using DMSO as a solvent, it is recommended to not exceed 5 ml/kg or 10% of injected volume, and for animal studies, the organic solvent portion should not exceed 10% 5, 6