• Dermatol Surg · Jan 1996

    Review Case Reports

    Ambulatory phlebectomy. A rare complication of local anesthetic: case report and literature review.

    • J A Olivencia.
    • Iowa Vein Center, Mercy West Health Center, Des Moines, USA.
    • Dermatol Surg. 1996 Jan 1; 22 (1): 53-5.

    BackgroundFull-thickness skin necrosis can occur after infiltration of 1.0% lidocaine with 1/100,000 epinephrine for ambulatory phlebectomy.ObjectiveTo demonstrate an exaggerated local response to epinephrine resulting in full-thickness skin necrosis and ultimately a permanent scar.MethodsA postoperative complication was clinically observed.ConclusionPermanent scar formation after ambulatory phlebectomy was found in a patient with a previous probable exaggerated local response to epinephrine. Uneventful phlebectomy resulted in the same patient when epinephrine was deleted from the local anesthetic, suggesting a local inability to eliminate epinephrine or an exaggerated local alpha-one response.

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