How should significant extravasation of hypertonic saline (HTS) to the subcutaneous tissue be managed?

The management of significant extravasation of hypertonic saline (HTS) to the subcutaneous tissue is best addressed by dilution with normal saline. When hypertonic saline leaks into the subcutaneous tissue, it can cause local cellular dehydration and swelling due to the hyperosmolarity of the solution. Diluting the extravasated fluid with normal saline helps to restore the osmotic balance and mitigate the effects of the hypertonic solution.

By introducing normal saline, which is isotonic, it effectively reduces the concentration of the hypertonic saline in the tissue, facilitating a more favorable environment for water movement and cellular recovery. This approach can reduce discomfort, promote tissue healing, and minimize potential complications associated with the hypertonic fluid's effects.

In contrast, other management strategies might not address the underlying issue effectively or could potentially exacerbate the situation. For example, applying a cold compress may provide temporary relief but does not resolve the osmotic imbalance. Surgical intervention could be excessive in most cases of extravasation unless there are severe complications, and observation alone would likely fail to address the immediate needs of the affected tissue. Thus, dilution with normal saline is the most appropriate and effective course of action in this scenario.