Skin hypersensitivity following application of tissue adhesive (2-octyl cyanoacrylate)

Abstract

Tissue adhesives are commonly used for skin closure in both surgical and nonsurgical specialties. Although they are very well tolerated, tissue adhesives can induce a localized allergic response in 0.5% to 14% of patients. Allergic response can result in wound dehiscence, patient discomfort, increased healing time, and suboptimal esthetic results. We present two cases of allergic reaction to anterior neck incisions following topical application of tissue adhesives. The patients were managed with local wound care, steroid administration, and one with subsequent revision surgery. Clinicians who routinely use tissue adhesives should understand the incidence, risk factors, and management of allergic reaction to these products.

Incidence of Skin Sensitivity Following Dermabond Application in Pediatric Orthopedic Surgery

“…These previously described characteristics of allergic skin reactions to Dermabond were used to code the reaction types collected in this study. 10,[12][13][14][15][16]23 Ultimately, the reactions following Dermabond exposure that we documented in our cohort were most frequently characterized by erythema and itchiness around the surgical site, along with rashes, dehiscence, and wound discharge, similar to previous literature.…”

“…ACD is the most common allergic reaction described in the adult literature associated with the application of Dermabond. [10][11][12][13][14] The incidence of ACD following surgical application of Dermabond in adult orthopedic surgery ranges from 0.5% to 2.8%. [15][16][17] However, the incidence of skin reactions following Dermabond exposure in pediatric orthopedic surgery is unknown.…”

“…Allergic contact dermatitis (ACD) is a type IV hypersensitivity reaction defined by the presence of a localized and well-defined pruritic rash that appears within 2 weeks of exposure. ACD is the most common allergic reaction described in the adult literature associated with the application of Dermabond 10–14 . The incidence of ACD following surgical application of Dermabond in adult orthopedic surgery ranges from 0.5% to 2.8% 15–17 .…”

Bioadhesive Technology Platforms

“…Besides the FBR, the potential allergenicity of bioadhesive materials poses a substantial concern for individuals who may be sensitive to specific proteins or antigens. For example, bioadhesives containing components derived from animal sources such as collagen, gelatin, albumin, or fibrin may induce anaphylactic reactions in allergic patients. − Although synthetic polymers are generally associated with lower allergenicity, they too can elicit allergic responses . In view of this risk, applying personalized medicine approaches to bioadhesive development may be a valuable strategy to tailor formulations to individual patients based on their specific medical needs .…”

“…155−157 Although synthetic polymers are generally associated with lower allergenicity, they too can elicit allergic responses. 158 In view of this risk, applying personalized medicine approaches to bioadhesive development may be a valuable strategy to tailor formulations to individual patients based on their specific medical needs. 159 In the future, screening patients for potential allergies to bioadhesive components (including specific polymers, cross-linkers, and other additives) and adjusting the formulation of a bioadhesive accordingly could be performed prior to a clinical intervention to minimize the risk of adverse reactions.…”