Skin necrosis after intravenous calcium chloride administration as a complication of parathyroidectomy for secondary hyperparathyroidism: Report of four cases

Chi Ying Lin, Kun Chou Hsieh, Ming Chung Yeh, Shyr Ming Sheen-Chen, Fong Fu Chou

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Intravenous (i.v.) calcium chloride is usually given to treat symptomatic hypocalcemia; however, the extravasation of calcium solution may cause soft tissue and skin necrosis. After parathyroidectomy and autotransplantation for secondary hyperparathyroidism associated with end-stage renal failure, i.v. calcium infusion is often necessary to treat severe postoperative hypocalcemia. We reviewed 371 patients who underwent parathyroidectomy for secondary hyperparathyroidism between January 2000 and June 2005, 96 of whom received i.v. calcium postoperatively for symptomatic hypocalcemia. We report the cases of three (3%) of our own patients and of one patient referred to our hospital, who suffered skin necrosis after i.v. calcium solution administration. These reports show that i.v. calcium should be administered into large veins, or via a central line, and diluted in an appropriate volume of solution. Moreover, the calcium solution infusion should be ceased if the patient complains of tenderness over the injection site. If skin necrosis develops, we suggest early debridement and a simple split thickness skin graft to repair the skin defect. We report our experience to remind surgeons of the danger of calcium chloride injection and to discuss ways of preventing and treating this complication.

Original languageEnglish
Pages (from-to)778-781
Number of pages4
JournalSurgery Today
Volume37
Issue number9
DOIs
Publication statusPublished - Sep 1 2007
Externally publishedYes

Fingerprint

Parathyroidectomy
Calcium Chloride
Secondary Hyperparathyroidism
Necrosis
Calcium
Skin
Hypocalcemia
Injections
Autologous Transplantation
Debridement
Intravenous Infusions
Chronic Kidney Failure
Veins
Transplants

Keywords

  • Calcium chloride
  • Parathyroidectomy
  • Skin necrosis

ASJC Scopus subject areas

  • Surgery

Cite this

Skin necrosis after intravenous calcium chloride administration as a complication of parathyroidectomy for secondary hyperparathyroidism : Report of four cases. / Lin, Chi Ying; Hsieh, Kun Chou; Yeh, Ming Chung; Sheen-Chen, Shyr Ming; Chou, Fong Fu.

In: Surgery Today, Vol. 37, No. 9, 01.09.2007, p. 778-781.

Research output: Contribution to journalArticle

@article{4aca81e970e647de9039a5a89684e81d,
title = "Skin necrosis after intravenous calcium chloride administration as a complication of parathyroidectomy for secondary hyperparathyroidism: Report of four cases",
abstract = "Intravenous (i.v.) calcium chloride is usually given to treat symptomatic hypocalcemia; however, the extravasation of calcium solution may cause soft tissue and skin necrosis. After parathyroidectomy and autotransplantation for secondary hyperparathyroidism associated with end-stage renal failure, i.v. calcium infusion is often necessary to treat severe postoperative hypocalcemia. We reviewed 371 patients who underwent parathyroidectomy for secondary hyperparathyroidism between January 2000 and June 2005, 96 of whom received i.v. calcium postoperatively for symptomatic hypocalcemia. We report the cases of three (3{\%}) of our own patients and of one patient referred to our hospital, who suffered skin necrosis after i.v. calcium solution administration. These reports show that i.v. calcium should be administered into large veins, or via a central line, and diluted in an appropriate volume of solution. Moreover, the calcium solution infusion should be ceased if the patient complains of tenderness over the injection site. If skin necrosis develops, we suggest early debridement and a simple split thickness skin graft to repair the skin defect. We report our experience to remind surgeons of the danger of calcium chloride injection and to discuss ways of preventing and treating this complication.",
keywords = "Calcium chloride, Parathyroidectomy, Skin necrosis",
author = "Lin, {Chi Ying} and Hsieh, {Kun Chou} and Yeh, {Ming Chung} and Sheen-Chen, {Shyr Ming} and Chou, {Fong Fu}",
year = "2007",
month = "9",
day = "1",
doi = "10.1007/s00595-006-3426-z",
language = "English",
volume = "37",
pages = "778--781",
journal = "Surgery Today",
issn = "0941-1291",
publisher = "Springer Japan",
number = "9",

}

TY - JOUR

T1 - Skin necrosis after intravenous calcium chloride administration as a complication of parathyroidectomy for secondary hyperparathyroidism

T2 - Report of four cases

AU - Lin, Chi Ying

AU - Hsieh, Kun Chou

AU - Yeh, Ming Chung

AU - Sheen-Chen, Shyr Ming

AU - Chou, Fong Fu

PY - 2007/9/1

Y1 - 2007/9/1

N2 - Intravenous (i.v.) calcium chloride is usually given to treat symptomatic hypocalcemia; however, the extravasation of calcium solution may cause soft tissue and skin necrosis. After parathyroidectomy and autotransplantation for secondary hyperparathyroidism associated with end-stage renal failure, i.v. calcium infusion is often necessary to treat severe postoperative hypocalcemia. We reviewed 371 patients who underwent parathyroidectomy for secondary hyperparathyroidism between January 2000 and June 2005, 96 of whom received i.v. calcium postoperatively for symptomatic hypocalcemia. We report the cases of three (3%) of our own patients and of one patient referred to our hospital, who suffered skin necrosis after i.v. calcium solution administration. These reports show that i.v. calcium should be administered into large veins, or via a central line, and diluted in an appropriate volume of solution. Moreover, the calcium solution infusion should be ceased if the patient complains of tenderness over the injection site. If skin necrosis develops, we suggest early debridement and a simple split thickness skin graft to repair the skin defect. We report our experience to remind surgeons of the danger of calcium chloride injection and to discuss ways of preventing and treating this complication.

AB - Intravenous (i.v.) calcium chloride is usually given to treat symptomatic hypocalcemia; however, the extravasation of calcium solution may cause soft tissue and skin necrosis. After parathyroidectomy and autotransplantation for secondary hyperparathyroidism associated with end-stage renal failure, i.v. calcium infusion is often necessary to treat severe postoperative hypocalcemia. We reviewed 371 patients who underwent parathyroidectomy for secondary hyperparathyroidism between January 2000 and June 2005, 96 of whom received i.v. calcium postoperatively for symptomatic hypocalcemia. We report the cases of three (3%) of our own patients and of one patient referred to our hospital, who suffered skin necrosis after i.v. calcium solution administration. These reports show that i.v. calcium should be administered into large veins, or via a central line, and diluted in an appropriate volume of solution. Moreover, the calcium solution infusion should be ceased if the patient complains of tenderness over the injection site. If skin necrosis develops, we suggest early debridement and a simple split thickness skin graft to repair the skin defect. We report our experience to remind surgeons of the danger of calcium chloride injection and to discuss ways of preventing and treating this complication.

KW - Calcium chloride

KW - Parathyroidectomy

KW - Skin necrosis

UR - http://www.scopus.com/inward/record.url?scp=34548189502&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=34548189502&partnerID=8YFLogxK

U2 - 10.1007/s00595-006-3426-z

DO - 10.1007/s00595-006-3426-z

M3 - Article

C2 - 17713732

AN - SCOPUS:34548189502

VL - 37

SP - 778

EP - 781

JO - Surgery Today

JF - Surgery Today

SN - 0941-1291

IS - 9

ER -