Thornton Nicholas J, Gibson Bernard R, Ferry Andrew M
Dermatology, University of Texas Medical Branch, Galveston, USA.
Plastic and Reconstructive Surgery, Baylor College of Medicine, Houston, USA.
Cureus. 2021 Mar 24;13(3):e14090. doi: 10.7759/cureus.14090.
In more recent years, the use of medical adhesives in lieu of sutures or staples has become increasingly common for the closure of post-surgical and traumatic incisions in areas of the skin where tension is low. While medical adhesives possess many advantages and little risk of adverse side effects, there are increasing numbers of accounts in the medical literature of allergic contact dermatitis (ACD) caused by specific components contained within the medical adhesives. The goal of this paper is to provide physicians with a differential diagnosis when faced with complications after the use of medical adhesives for wound closure. Additionally, this paper aims to delineate the differences among the most commonly used adhesives, provide a rationale for assessing an individual's personal risk of developing ACD, and to highlight the unique advantages and disadvantages of each adhesive. Dermabond® appears to be the most versatile adhesive with the lowest risk of ACD. However, because of its high cost, it may not be appropriate for all patients. While Mastisol® can only be utilized in combination with a dressing, such as Steri-Strips®, it is much more affordable than Dermabond and is still capable of providing an effective wound closure. Due to these factors, it is our recommendation that Dermabond is considered the first-line medical adhesive due to its versatility and strength, while Mastisol can be readily employed in situations with financial consideration. As the number of patients treated with medical adhesives continues to grow, physicians should anticipate an increase in the number of cases of ACD secondary to adhesive sensitization. It is imperative for physicians to be able to differentiate between a case of ACD and another potentially more serious complication, such as cellulitis. We hope that this paper will assist providers in distinguishing adhesive-induced ACD and other complications, identifying patients at risk of ACD from adhesive use, and provide a basis for which adhesives are most appropriate for any given patient.
近年来，在皮肤张力较小区域的手术和创伤切口闭合中，使用医用粘合剂代替缝线或吻合钉已变得越来越普遍。虽然医用粘合剂具有许多优点且不良反应风险很小，但医学文献中由医用粘合剂中特定成分引起的过敏性接触性皮炎（ACD）病例数量却在不断增加。本文的目的是在医生面对使用医用粘合剂进行伤口闭合后出现的并发症时，为其提供鉴别诊断。此外，本文旨在阐明最常用粘合剂之间的差异，为评估个体发生ACD的个人风险提供依据，并突出每种粘合剂的独特优缺点。皮肤粘合剂（Dermabond®）似乎是用途最广泛且发生ACD风险最低的粘合剂。然而，由于其成本高昂，可能并不适用于所有患者。虽然速得纱（Mastisol®）只能与诸如无菌胶带（Steri-Strips®）等敷料联合使用，但它比皮肤粘合剂便宜得多，并且仍然能够有效闭合伤口。由于这些因素，我们建议由于其多功能性和强度，皮肤粘合剂被视为一线医用粘合剂，而速得纱在考虑经济因素的情况下可以很容易地使用。随着使用医用粘合剂治疗的患者数量持续增加，医生应预计因粘合剂致敏导致的ACD病例数量会增加。医生必须能够区分ACD病例和另一种可能更严重的并发症，如蜂窝织炎。我们希望本文将有助于医疗人员区分粘合剂引起的ACD和其他并发症，识别因使用粘合剂而有ACD风险的患者，并为哪种粘合剂最适合任何特定患者提供依据。
