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Localised bullous eruptions and epidermal detachment from the extravasation of hydroxyethyl starch (Voluven)
  1. James London1,
  2. Stan Tay2,
  3. Brigid Brown2,
  4. Chasari Tancharoen3
  1. 1Department of Anaesthesia, Flinders Medical Centre, Bedford Park, South Australia, Australia
  2. 2Department of Anaesthesia, Royal Darwin Hospital, Tiwi, Northern Territory, Australia
  3. 3Department of Medicine, St Vincent's Hospital, Fitzroy, Victoria, Australia
  1. Correspondence to Dr Stan Tay, stanley.tay{at}


Extravasation occurs frequently with intravenous infusions. In this case report we describe the occurrence of epidermal detachment and multiple cutaneous bullous eruptions in a patient’s forearm following the extravasation of hydroxyethyl starch (Voluven, Fresenius Kabi)—a colloid solution derived from corn starch, which is used to replace lost blood volume. The patient’s affected body surface area was managed under the direction of our plastic surgical team. Despite a prolonged admission in hospital from other perioperative complications, he made a full recovery and was successfully discharged home. The probable pathogenesis relevant to extravasation of Voluven is discussed; as well as its management principles.

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