Allergic reaction to Dermabond in gynaecologic surgery

Abstract

A 63-year-old female presented on post-operative day 7 status post total laparoscopic hysterectomy and bilateral salpingo-oophorectomy with sudden onset erythema and pruritus around all four port site incisions. Upon physical exam, a thin layer of Dermabond remained in place on the epidermis and an erythematous raised wheal (1-3 cm radius) surrounded each incision. The patient was advised to remove the skin adhesive with petroleum jelly and acetone. Dermatologist evaluation confirmed the suspicion of an allergic reaction to Dermabond and recommended application of a thin topical layer of hydrocortisone 1% to affected areas 2-4 times per day. Skin inflammation and pruritus abated completely within 2 days. Confirmatory allergic patch testing performed three years after initial reaction was positive for ethyl cyanoacrylate.Dermabond is a liquid topical skin adhesive containing a monomeric 2-octyl cyanoacrylate formulation and the colorant D&C Violet #2 which should slough off with desquamation of the epidermis 7-14 days after application. There has never been a reported case resulting from gynaecologic surgery until now.