BACKGROUND
Chlorhexidine gluconate is one of the most effective surgical preparations, but it has known potential ocular and ototoxicity.
OBJECTIVE
To review reported cases of ocular and ototoxicity caused by chlorhexidine and summarize the clinical situations in which chlorhexidine toxicity occurred.
METHODS
We performed a systematic review of PubMed and the Web of Science.
RESULTS
Fourteen cases reported sensorineural hearing loss from chlorhexidine instilled into the ear. Of the 38 cases of ocular toxicity, 8 cases were caused by direct instillation in the eye and 17 involved periocular surgical preparation. In the remaining cases, the area prepped was less defined. Seven cases involved preparation of the face, 1 for the scalp, 2 cases were drips from distant sites, and 3 cases did not specify the means of exposure.
CONCLUSION
The vast majority of toxicity occurred in patients undergoing general anesthesia and was rarely seen in situations where surgery was performed by dermatologists. Ultimately, it should be up to the individual physician to decide whether chlorhexidine is the best choice for a particular outpatient procedure.
Medical tattooing has been used in various circumstances. In this review, the authors focus on the utilization of medical tattooing in the head and neck region as a minimally invasive alternative to corrective surgeries. It is mostly used to camouflage noticeable surgical scars on scalp, face, and perioral areas. Its use has also been described in cases of concealing depigmentation or hypopigmentation, hair loss, postirradiation telangiectasia, and congenital vascular malformation. These procedures are well-tolerated and safe. Its effects are long-lasting and satisfactory, leading to improvement in self-esteem and increased quality of life in treated patients. The limitations of medical tattooing in such uses include high technical requirement, color fading and alteration, unpredictable outcomes in scarred tissue, and potential cutaneous reactions. It also carries a risk of infection, albeit very low due to standardized sterilization process in a medical setting. The authors conclude that medical tattooing in the head and neck region may serve as an excellent option for patients who seek for cosmetic improvement in their deformities and/or discoloration but would prefer to avoid surgery.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.