Type IV Hypersensitivity Reaction to Dermabond (2-Octyl Cyanoacrylate) in Plastic Surgical Patients: A Retrospective Study

Abstract

Background: The Dermabond (2-octyl cyanoacrylate) is a commonly used skin adhesive in plastic surgery. There are some reports in the literature regarding Dermabond associated contact dermatitis. In this retrospective cohort study, we evaluated the incidence and characteristics of contact dermatitis (type IV hypersensitivity reaction) post application of Dermabond (Trade name PRINEO manufactured by ETHICON) in patients who underwent plastic surgical breast procedures in our hospital. Methods: Sixty patients had undergone plastic surgical breast procedures (mastopexy and reduction mammoplasty) with Dermabond application over the period of last 3 years in our hospital. The records of these 60 patients were studied retrospectively. Results: Four patients (6.6%) out of the 60 patients taken for study had developed type IV hypersensitivity reaction to Dermabond. All of these patients presented with pruritus and skin rash in the second week of their post-operative period and none of them had any known past allergic history. Conclusion: We conclude that the incidence of type IV hypersensitivity allergic reaction post application of Dermabond (2-octyl cyanoacrylate) is significantly high and its possibility should be explained to the patients prior to its application.

Incidence of Skin Sensitivity Following Dermabond Application in Pediatric Orthopedic Surgery

“…Gonzalo-Garijo et al 19 described 3 cases of allergic contact dermatitis to Dermabond following pediatric orthopedic surgery, characterizing reactions by the presence of “pruritus,” 19 and “a papulo-vesicular eruption” around the surgical site. Liu et al 18 similarly described a child with allergic contact dermatitis after Dermabond application, characterizing the reaction by the presence of “itching, erythema, and serous weeping.” These previously described characteristics of allergic skin reactions to Dermabond were used to code the reaction types collected in this study 10,12–16,23 . 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.…”

“…Estimations of the incidence of ACD following Dermabond exposure vary between surgical specialties. Nakagawa et al 10 and Alotaibi et al 23 reported the incidence rate in adult plastic surgery ~7.0%. In contrast, Park et al 16 and Chalmers et al 15 reported a Dermabond skin sensitivity in adults after general (2.7%) and elective orthopedic surgery (0.5%), respectively.…”

Severe Hypersensitivity Reaction to Dermabond Prineo After Anterior Cervical Discectomy and Fusion

“…Despite its many benefits, Prineo is not without its risks. Early reports of the adverse reactions to this adhesive were mainly within the plastic surgery and dermatology literature [11][12][13] . However, with the increased adoption of its use in orthopaedic surgery, a surge of publications has developed within the total joint arthroplasty literature [3][4][5][6][7][8][9] .…”

Tackling Acrylate Allergy: The Sticky Truth

“…33,34 Although robust prospective data are limited, studies suggest that 2% to 14% of patients develop postoperative skin reactions following 2-octyl cyanoacrylate application. [35][36][37] It has been shown that sensitization to tissue adhesives often occurs after the first application, followed by an eruption of ACD as long as a month later, which can create confusion about the nature of the rash for patients and health care providers alike, who may for instance attribute it to infection rather than allergy. 38 In the orthopedic literature, a woman with a known history of acrylic nail ACD had knee arthroplasty failure attributed to acrylic bone cement with resolution of the joint symptoms after changing to a cementless device.…”