Ricciardo Bernadette M, Nixon Rosemary L, Tam Mei Mui, Radic Ross R, Ricciardo Brendan J
Orthopedics. 2020 Nov 1;43(6):e515-e522. doi: 10.3928/01477447-20200827-01. Epub 2020 Sep 3.
The Dermabond Prineo skin closure system (Ethicon, Somerville, New Jersey) is a wound closure device that combines a 2-octyl cyanoacrylate liquid adhesive and a self-adhesive polyester mesh. Although cyanoacrylates traditionally have been associated with low rates of sensitization, allergic contact dermatitis (ACD) to Dermabond products is being increasingly reported after orthopedic surgery. The authors describe the first case series of ACD to Dermabond Prineo where patch testing confirmed the diagnosis in all patients. Six patients who had suspected Dermabond Prineo ACD after lower limb orthopedic surgery were assessed. Of these patients, 5 had itching within 4 days of surgery and rash within 5 days. All 5 of these patients reported previous exposure to Dermabond products. All patients had removal of the adhesive and mesh earlier than planned and were treated with corticosteroids. In addition, 4 patients received systemic antibiotics; however, only 1 had a microbiologically confirmed superficial skin infection. In all patients, the dermatitis resolved within 2 weeks of dressing removal, with no adverse effect on the orthopedic outcome. Patch testing showed positive reactions to Dermabond Prineo glue for all patients. Orthopedic surgeons should be aware of the potential for ACD to Dermabond Prineo, especially among patients with previous exposure to Dermabond products. The authors discuss the risk factors for ACD to Dermabond Prineo in the orthopedic cohort and provide recommendations for prevention and management. [Orthopedics. 2020;43(6):e515-e522.].
德玛邦德普瑞尼奥皮肤闭合系统（爱惜康公司，新泽西州萨默维尔）是一种伤口闭合装置，它将2-氰基丙烯酸辛酯液体粘合剂和自粘性聚酯网结合在一起。尽管传统上氰基丙烯酸酯类物质与低致敏率相关，但骨科手术后对德玛邦德产品发生过敏性接触性皮炎（ACD）的报道越来越多。作者描述了首例因德玛邦德普瑞尼奥导致的ACD病例系列，其中斑贴试验在所有患者中均确诊了该病。对6例下肢骨科手术后疑似德玛邦德普瑞尼奥所致ACD的患者进行了评估。在这些患者中，5例在术后4天内出现瘙痒，5天内出现皮疹。这5例患者均报告既往接触过德玛邦德产品。所有患者均比计划提前拆除了粘合剂和网，并接受了皮质类固醇治疗。此外，4例患者接受了全身性抗生素治疗；然而，只有1例经微生物学证实有浅表皮肤感染。所有患者在去除敷料后2周内皮炎均消退，对骨科手术结果无不良影响。斑贴试验显示所有患者对德玛邦德普瑞尼奥胶水均有阳性反应。骨科医生应意识到德玛邦德普瑞尼奥导致ACD的可能性，尤其是在既往接触过德玛邦德产品的患者中。作者讨论了骨科患者群体中德玛邦德普瑞尼奥所致ACD的危险因素，并提供了预防和管理建议。[《骨科》。2020年；43(6):e515-e522。]
