Allergic contact dermatitis to liquid adhesive, mesh system seen after orthopedic surgery
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Allergic contact dermatitis caused by a skin closure system that uses liquid adhesive and mesh has been reported after orthopedic procedures, especially in patients with past exposure to company products, according to published results.
Researchers analyzed six patients with suspected allergic contact dermatitis (ACD) after lower limb surgery. All patients’ wounds had been closed with Dermabond Prineo (Ethicon), a combination of a 2-octyl cyanoacrylate liquid adhesive and a self-adhesive polyester mesh.
According to the study, five patients, who all reported previous exposure to Dermabond products, reported itching and rash within 4 to 5 days of surgery. These patients received corticosteroids and had their adhesive and mesh removed. Four of these patients received antibiotics and one had a microbiologically confirmed superficial skin infection. At 2 weeks after dressing removal, ACD had resolved in all six patients.
“ACD is a type IV delayed-type hypersensitivity reaction that occurs when skin comes in contact with a chemical to which the individual has been previously sensitized.,” the researchers wrote in the study. “Once sensitization occurs, any future exposure to the allergen will result in ACD, often with increasingly rapid onset and more severe reactions,” they wrote.
“The use of two simple screening questions during the consent process may help to identify high-risk patients,” the researchers concluded. “All patients should be warned of the potential risk of ACD to Dermabond Prineo and should be advised to seek medical review if they have postoperative peri-incisional itching, oozing or rash.”
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