Accidental intra-arterial injection of enoxaparin sodium leading to abdominal wall expanding subcutaneous hematoma and abdominal wound: case report-vascular
IntroductionEnoxaparin sodium (Lovenox®) is a commonly used anticoagulant medication that is self-administered via subcutaneous injection to prevent the formation of pathologic blood clots. It is used as a bridge to long-term anticoagulation with warfarin in patients at high risk for thromboembolic...
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Frontiers Media S.A.
2025-01-01
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| Series: | Frontiers in Surgery |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fsurg.2025.1477926/full |
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| author | Caroline Howell Richard Simman Richard Simman Richard Simman |
| author_facet | Caroline Howell Richard Simman Richard Simman Richard Simman |
| author_sort | Caroline Howell |
| collection | DOAJ |
| description | IntroductionEnoxaparin sodium (Lovenox®) is a commonly used anticoagulant medication that is self-administered via subcutaneous injection to prevent the formation of pathologic blood clots. It is used as a bridge to long-term anticoagulation with warfarin in patients at high risk for thromboembolic events. It is generally well-tolerated and has a favorable safety profile. The most common injection site reactions caused by enoxaparin sodium are urticaria, ecchymosis, and skin and fat necrosis.Case ReportA 56 year-old female with extensive thromboembolic history was completing an enoxaparin sodium bridge to warfarin when she accidentally self-injected enoxaparin sodium into the left superficial epigastric artery, resulting in the formation of a large expanding hematoma and the development of hemorrhagic shock. Controlling the bleeding required reversal of anticoagulation, transfusion, and coil embolization of the affected arteries. Surgical evacuation of the hematoma was performed, and the resultant wound was managed postoperatively with negative pressure wound therapy (NPWT) for one month. After discontinuation of NPWT, the wound was allowed to heal by secondary intention using dressing changes.ConclusionsThe findings of this case report suggest that NPWT followed by conventional dressings can be used to close and heal the wound created by surgical hematoma evacuation. |
| format | Article |
| id | doaj-art-b66a6cdbf2e14c409416d77e6d9c6d36 |
| institution | Kabale University |
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| language | English |
| publishDate | 2025-01-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Surgery |
| spelling | doaj-art-b66a6cdbf2e14c409416d77e6d9c6d362025-01-22T07:12:58ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2025-01-011210.3389/fsurg.2025.14779261477926Accidental intra-arterial injection of enoxaparin sodium leading to abdominal wall expanding subcutaneous hematoma and abdominal wound: case report-vascularCaroline Howell0Richard Simman1Richard Simman2Richard Simman3University of Toledo College of Medicine and Life Sciences, Toledo, OH, United StatesUniversity of Toledo College of Medicine and Life Sciences, Toledo, OH, United StatesDivision of Plastic and Reconstructive Surgery, Department of Surgery, University of Toledo Medical Center, Toledo, OH, United StatesProMedica Health Network, Wound Care Program, Jobst Vascular Institute, Toledo, OH, United StatesIntroductionEnoxaparin sodium (Lovenox®) is a commonly used anticoagulant medication that is self-administered via subcutaneous injection to prevent the formation of pathologic blood clots. It is used as a bridge to long-term anticoagulation with warfarin in patients at high risk for thromboembolic events. It is generally well-tolerated and has a favorable safety profile. The most common injection site reactions caused by enoxaparin sodium are urticaria, ecchymosis, and skin and fat necrosis.Case ReportA 56 year-old female with extensive thromboembolic history was completing an enoxaparin sodium bridge to warfarin when she accidentally self-injected enoxaparin sodium into the left superficial epigastric artery, resulting in the formation of a large expanding hematoma and the development of hemorrhagic shock. Controlling the bleeding required reversal of anticoagulation, transfusion, and coil embolization of the affected arteries. Surgical evacuation of the hematoma was performed, and the resultant wound was managed postoperatively with negative pressure wound therapy (NPWT) for one month. After discontinuation of NPWT, the wound was allowed to heal by secondary intention using dressing changes.ConclusionsThe findings of this case report suggest that NPWT followed by conventional dressings can be used to close and heal the wound created by surgical hematoma evacuation.https://www.frontiersin.org/articles/10.3389/fsurg.2025.1477926/fullLovenoxsubcutaneous hematomaanticoagulantnegative pressure wound therapybleedingintra-arterial injection |
| spellingShingle | Caroline Howell Richard Simman Richard Simman Richard Simman Accidental intra-arterial injection of enoxaparin sodium leading to abdominal wall expanding subcutaneous hematoma and abdominal wound: case report-vascular Frontiers in Surgery Lovenox subcutaneous hematoma anticoagulant negative pressure wound therapy bleeding intra-arterial injection |
| title | Accidental intra-arterial injection of enoxaparin sodium leading to abdominal wall expanding subcutaneous hematoma and abdominal wound: case report-vascular |
| title_full | Accidental intra-arterial injection of enoxaparin sodium leading to abdominal wall expanding subcutaneous hematoma and abdominal wound: case report-vascular |
| title_fullStr | Accidental intra-arterial injection of enoxaparin sodium leading to abdominal wall expanding subcutaneous hematoma and abdominal wound: case report-vascular |
| title_full_unstemmed | Accidental intra-arterial injection of enoxaparin sodium leading to abdominal wall expanding subcutaneous hematoma and abdominal wound: case report-vascular |
| title_short | Accidental intra-arterial injection of enoxaparin sodium leading to abdominal wall expanding subcutaneous hematoma and abdominal wound: case report-vascular |
| title_sort | accidental intra arterial injection of enoxaparin sodium leading to abdominal wall expanding subcutaneous hematoma and abdominal wound case report vascular |
| topic | Lovenox subcutaneous hematoma anticoagulant negative pressure wound therapy bleeding intra-arterial injection |
| url | https://www.frontiersin.org/articles/10.3389/fsurg.2025.1477926/full |
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