Impact of repeated surgical procedures on the incidence and prevalence of latex allergy: A prospective study of 1263 children

Hourihane, Jonathan; Allard, J; Wade, Angela; McEwan, Angus; Ströbel, Stephan

doi:10.1067/mpd.2002.123288

Cited by 41 publications

(28 citation statements)

References 12 publications

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“…Children with spina bifida are usually first operated in the first 24 to 48 hours of life, but weeks may elapse before a child is operated because of hydrocephalus of other origin. In recent studies, there are also conflicting results about operations in the first year of life [7,18,19]. As in our study all children had myelomeningocele and were operated very soon after birth, we cannot draw any conclusions regarding this issue.…”

Section: Discussioncontrasting

confidence: 54%

Influence of the type of operations on the development of latex sensitization in children with myelomeningocele

Mazon¹,

Nieto²,

Pamies³

et al. 2005

Journal of Pediatric Surgery

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Section: Discussioncontrasting

confidence: 54%

Influence of the type of operations on the development of latex sensitization in children with myelomeningocele

Mazon¹,

Nieto²,

Pamies³

et al. 2005

Journal of Pediatric Surgery

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“…Unplanned re-operation (UR) has been reported to be a cause of increasing patient waiting list and prolonged hospital stay, subsequently raising hospital costs [1][2][3][4][5]. Additionally, UR is known to greatly affect patient satisfaction and trust-level with the healthcare service providers, while diminishing hospital staff self-confidence [6,7]. Increasing re-operations rate is also correlated with higher morbidity and mortality [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Predictors and causes of unplanned re-operations in outpatient plastic surgery: a multi-institutional analysis of 6749 patients using the 2011 NSQIP database

Lim

Jordan

Jain

et al. 2014

Journal of Plastic Surgery and Hand Surgery

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Studies that evaluate the predictors and causes of unplanned re-operation in outpatient plastic surgery. This study retrospectively reviewed the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) and identified all plastic surgery outpatient cases performed in 2011. Multiple logistic regression analysis was utilised to identify independent risk factors and causes of unplanned reoperations. Of the 6749 outpatient plastic surgery cases identified, there were 125 (1.9%) unplanned re-operations (UR). Regression analysis demonstrated that body mass index (BMI, OR = 1.041, 95% CI = 1.019-1.065), preoperative open wound/wound infection (OR = 3.498, 95% CI = 1.593-7.678), American Society of Anesthesiologists (ASA) class 3 (OR = 2.235, 95% CI = 1.048-4.765), and total work relative value units (RVU, OR = 1.014, 95% CI = 1.005-1.024) were significantly predictive of UR. Additionally, the presence of any complication was significantly associated with UR (OR = 15.065, 95% CI = 5.705-39.781). In an era of outcomes-driven medicine, unplanned re-operation is a critical quality indicator for ambulatory plastic surgery facilities. The identified risk factors will aid in surgical planning and risk adjustment.

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“…Any previous surgical procedure increases the odds of NRL sensitization by 13 times in a study on 1263 children without spina bifida, whose latex specific IgE and skin prick tests were examined at eligible operations [78]. According to our data it may also be concluded, that by primary latex prophylaxis during surgery, anesthesia and in pediatric wards the prevalence of NRL sensitization can be sufficiently reduced even in the high risk group of spina bifida patients.…”

Section: Effects Of Latex Prophylaxismentioning

confidence: 69%

“…The correlation of repeated surgeries and latex sensitization was described in several studies [28,[75][76][77][78]. The principles of a latex prophylaxis programme were published by the Task Force on Allergic Reactions to Latex in 1993 ( Table 2) at the American Academy of Allergy and Immunology [23].…”

Section: Effects Of Latex Prophylaxismentioning

confidence: 99%

Natural Rubber Latex Allergy in Pediatric Patients

Cremer¹,

Rihs²,

Raulf‐Heimsoth³

2008

CPR

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During the last fifteen years better hygienic standards led to an increased consumption of natural rubber latex (NRL) gloves for the protection of medical staff. At the same time case reports about an IgE-mediated allergy to NRL sometimes causing life-threatening anaphylactic reactions came up. This allergy was different from the well-known type IV reactions caused by latex additives. Health care workers and patients with multiple surgery surgeries were identified as high risk groups. For unknown reasons patients with spina bifida (SB) showed the highest prevalence of NRL-specific IgE-antibodies. A pre-existing atopy increased the risk of latex sensitization. Allergic reactions were caused mainly by medical procedures, especially surgeries, if latex gloves and other latex containing devices were used.Meanwhile some allergenic proteins in NRL (named Hev b in accordance with the rubber tree Hevea brasiliensis) could be identified. Patients in different risk groups showed distinct prevalences of sensitization to these allergens. The way of the allergen uptake (aerogen or by direct mucosal contact during surgeries) played an important role in the sensitization to different allergens. Most of the latex allergens like Hev b 1, Hev b 3, Hev b 6.02 have been totally sequenced. Since the sequence of all registrated allergens (Hev b 1 -Hev b 13) is known, it was possible to localize in Hev b 1, Hev b 5 and Hev b 6.01 several IgE binding sites as well as T cell epitopes.Cross-reacting antibodies between NRL and numerous fruit were described and for some proteins structural homologies were well characterized.For the in vitro diagnosis of NRL allergy serologic tests with improved extracts and recombinant allergens (for instance ImmunoCAP TM system) are available. NRL protein extracts for skin prick tests were difficult to standardize. The use of natural extracts in combination with recombinant latex allergens could be one possible future perspective for skin testing.The problem of NRL allergy is still not resolved but significant progress has been made in its prevention. In high risk patients like persons with spina bifida a primary prophylaxis was performed with success, but also secondary or tertiary prophylaxis allows safe operations without symptoms of NRL allergy.

show abstract

Impact of repeated surgical procedures on the incidence and prevalence of latex allergy: A prospective study of 1263 children

Cited by 41 publications

References 12 publications

Influence of the type of operations on the development of latex sensitization in children with myelomeningocele

Influence of the type of operations on the development of latex sensitization in children with myelomeningocele

Predictors and causes of unplanned re-operations in outpatient plastic surgery: a multi-institutional analysis of 6749 patients using the 2011 NSQIP database

Natural Rubber Latex Allergy in Pediatric Patients

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