Chemical Burn Secondary to Propofol Extravasation

A 58-year-old female presented to the emergency department (ED) with pain and swelling to the right arm after receiving propofol during an outpatient procedure for nasal polyps. During the procedure, it was noted that propofol had infiltrated at the antecubital intravenous (IV) site. A new IV line was inserted, and the procedure was completed. The patient was discharged from the hospital and then presented to our ED. Examination showed a 7-cm-by-8-cm denuded area with erythema and edema in the antecubital region (1% total body surface area). An hour after presentation, ecchymosis developed medially (Figure). There was small amount of serous drainage and tenderness to palpation. She was neurovascularly intact. The burn service was consulted. The patient was admitted to the burn unit and treated with antibiotics. She received a skin graft and discharged on post-op day 5 without any complications.