Causes of subcutaneous solution leakage and treatment of hand swelling step by step in a safe and medical manner

Many people notice swelling around the needle site or in the hand after a cannula is inserted, and this is usually due to the leakage of the solution under the skin. This issue is typically minor and resolves quickly, but it can sometimes cause pain or inflammation if not treated properly. In this article, we will explain the causes of solution leakage under the skin, how to safely and medically handle hand swelling after the infusion, and when it is necessary to see a doctor.

*** Causes of Solution Leakage Under the Skin ***

Solution leakage under the skin occurs when the solution does not enter the vein properly and instead accumulates under the skin. These causes can be due to human error or patient-specific conditions. Some of the most common causes include:

Incorrect Cannula Insertion
If the cannula (intravenous catheter) is not correctly positioned inside the vein, the solution will leak under the skin. This sometimes happens with less experienced nurses.
Weak or Fragile Veins
Small and fragile veins, especially in children or the elderly, are more prone to leakage, requiring a skilled nurse to select the appropriate vein.
Venous Hardening
Some patients, such as cancer patients, undergo repeated blood draws or cannula insertions, which leads to hardening of the veins and increases the risk of leakage.
Patient Movement During Infusion
If the patient moves too much during the infusion, the cannula might shift out of the vein, causing leakage, especially during long sessions when the patient is uncomfortable.
Obesity
For individuals with extreme obesity, it can be difficult for the nurse to locate a vein easily, which can increase the likelihood of leakage.

Types of Intravenous Fluids and Their Uses
Intravenous fluids are liquids injected directly into the vein, used by doctors in situations like dehydration, mineral deficiencies, or to support the body during fatigue or after surgery. Here are some of the most common types of fluids:

Saline Solution (NaCl)

0.9% NaCl: The most common solution, used for fluid replacement.
3% NaCl: A stronger solution used to treat severe sodium deficiency in the blood.

Glucose Solutions (Dextrose)

5% Glucose: Provides energy and is suitable for dehydration.
10% or 20% Glucose: Used when the body needs more energy after surgery or burns.

Ringer’s Solution or Lactated Ringer’s
Contains salts like sodium, potassium, and calcium, used for fluid replacement after severe diarrhea or burns.
Hartmann’s Solution
A type of Ringer's lactate solution, used to support the body in cases of bleeding or severe dehydration.
Vitamins and Mineral Solutions
Contains Vitamin C, Vitamin B, iron, calcium, and is used to improve immunity or treat nutritional deficiencies.
Electrolyte Solutions
Contains minerals like magnesium and potassium, essential after severe vomiting or diarrhea.
Albumin Solution
Used to treat low albumin levels in the blood and helps raise blood pressure and improve overall body condition.
Total Parenteral Nutrition (TPN)
Contains all the nutrients the body needs (carbohydrates, proteins, fats, vitamins) and is used when the patient cannot eat at all.
Antibiotic or Antiviral Solutions
Injected directly into the vein to treat severe infections like pneumonia or sepsis.
Dialysis Fluids
Used to clean the blood from toxins in kidney failure patients.

*** Causes of Solution Leakage Under the Skin ***

Solution leakage under the skin happens when the solution does not enter the vein correctly and accumulates under the skin. These causes can be due to human error or patient-specific conditions. Some of the most common causes include:

Incorrect Cannula Insertion
If the cannula (intravenous catheter) is not properly placed inside the vein, the solution will leak under the skin. This can sometimes occur with less experienced nurses.
Weak or Fragile Veins
Small and fragile veins, especially in children or the elderly, are more prone to leakage. This requires a skilled nurse to select the right vein.
Venous Hardening
Some patients, such as cancer patients, undergo repeated blood draws or cannula insertions, which lead to venous hardening and increase the risk of leakage.
Patient Movement During Infusion
If the patient moves too much during the infusion, the cannula may shift slightly out of the vein, causing leakage. This is especially common during long sessions when the patient is uncomfortable.
Obesity
For individuals with severe obesity, finding a vein can be more difficult, which increases the likelihood of leakage.

Types of Intravenous Fluids and Their Uses
Intravenous fluids are liquids injected directly into the vein and are used by doctors for cases like dehydration, mineral deficiencies, or to support the body during fatigue or after surgery. Here are some of the most common types of fluids:

Saline Solution (NaCl)

0.9% NaCl: The most common solution, used for fluid replacement.
3% NaCl: A stronger solution used to treat severe sodium deficiency in the blood.

Glucose Solutions (Dextrose)

5% Glucose: Provides energy and is suitable for dehydration.
10% or 20% Glucose: Used when the body needs more energy after surgery or burns.

Ringer’s Solution or Lactated Ringer’s
Contains salts like sodium, potassium, and calcium, used for fluid replacement after severe diarrhea or burns.
Hartmann’s Solution
A type of Ringer's lactate solution, used to support the body in cases of bleeding or severe dehydration.
Vitamins and Mineral Solutions
Contains Vitamin C, Vitamin B, iron, calcium, and is used to improve immunity or treat nutritional deficiencies.
Electrolyte Solutions
Contains minerals like magnesium and potassium, which are important after severe vomiting or diarrhea.
Albumin Solution
Used to treat low albumin levels in the blood and helps raise blood pressure and improve overall body condition.
Total Parenteral Nutrition (TPN)
Contains all the nutrients the body needs (carbohydrates, proteins, fats, vitamins) and is used when the patient is unable to eat at all.
Antibiotic or Antiviral Solutions
Injected directly into the vein to treat severe infections like pneumonia or sepsis.
Dialysis Fluids
Used to clean the blood of toxins in kidney failure patients.

1. Protect the Area from the Sun
Avoid exposing the swollen area to direct sunlight, as heat can increase inflammation. Make sure to cover the area well if you need to go outside.

2. Use Cold Compresses for the First 24 Hours
Apply cold compresses (not directly on the skin) for 15–20 minutes every few hours. This helps reduce swelling and inflammation in the initial stages.

3. After 24 Hours, Use Warm Compresses
Warm compresses help activate blood circulation and assist the body in draining accumulated fluids faster. Repeat the compresses 2–3 times daily for up to two weeks.

4. Raise Your Hand Above Heart Level
Try to keep your hand elevated on a pillow to reduce fluid accumulation and speed up healing.

5. Clean the Area Regularly
If there’s any wound or redness, make sure the area is clean, and use safe antiseptic solutions recommended by the doctor.

6. Follow the Prescribed Medications
The doctor may prescribe painkillers or antibiotics depending on the case. Follow the instructions carefully, and don’t stop the treatment on your own, even if the swelling reduces.

❄️ 7. Avoid Using the Affected Hand
Do not lift heavy objects or strain the hand to avoid worsening the swelling.

8. Light Massage (If Approved by the Doctor)
In some cases, gentle massage from the bottom upwards may help drain the fluids, but it should be done only with the doctor's approval.

9. See a Doctor if Severe Symptoms Appear
If you notice fever, severe redness, bruising, or the swelling persists for a long time, you need to see a doctor immediately. The condition may require medical intervention or antibiotics.

How to Treat Swelling in the Hand After Solution Leakage or Cannula Insertion?

First Step: Remove the Cannula Immediately
If the doctor has not removed it yet, it should be removed promptly to prevent further leakage and worsening of the condition.

Medications the Doctor Might Prescribe:

Anti-inflammatory drugs (like ibuprofen) to reduce pain and swelling.
Antihistamines if there is an allergic reaction.
Steroids for severe inflammation.
Antibiotics if there is an infection.

Light Compression:
Using a light bandage or elastic wrap can help reduce swelling, but it should not be too tight.

Physical Therapy:
If the swelling persists for a long time or affects the movement of the hand, the doctor may recommend physical therapy sessions to improve the condition.

Specialists for Treating Cannula or Solution Leakage Complications

The appropriate doctor to treat complications depends on the severity of the case, but generally, the following specialists are the most suitable:

Internal Medicine Doctor
This is usually the first doctor to consult for monitoring the condition and assessing the severity of the leakage. They will observe swelling, inflammation, pain, or any accompanying symptoms.
Vascular Specialist
If there is blockage in the veins or arteries in the hand, or if symptoms like cold extremities or discoloration appear, a vascular specialist's intervention is necessary.
Dermatologist
If there is skin irritation, chemical burns, or skin allergies at the cannula or leakage site, a dermatologist should be consulted.
Plastic Surgeon or General Surgeon
If tissue necrosis or pus accumulation (abscess) occurs, surgical intervention might be required to clean or reconstruct the tissue.
Infectious Disease Specialist
If the condition develops into severe bacterial infection or sepsis, an infectious disease specialist will be required.