Fraval Andrew, Zappley Nicolina, Hozack William J
Rothman Institute Orthopaedics at Thomas Jefferson University Hospital, Philadelphia, PA, USA.
Arthroplast Today. 2023 Sep 19;23:101201. doi: 10.1016/j.artd.2023.101201. eCollection 2023 Oct.
The use of iodophor-impregnated adhesive drapes have become almost universally incorporated into standard practice of arthroplasty draping technique. Iodine-related allergies in patients planned for joint replacement present a challenge in terms of the best course of action to minimize complications and optimize outcomes.
This is a retrospective case series of patients that received an iodophor-impregnated drape as part of draping for a total hip or knee arthroplasty at a single orthopaedic-specific hospital with documented iodine-related allergies. From 2015 to 2023, 9816 total hip arthroplasty and total knee arthroplasty cases were reviewed, and 135 were documented to have an iodine-related allergy for a prevalence of 1.38%. Intraoperative and postoperative records were reviewed to screen for an allergic reaction or wound healing issues that may have been related to an adverse reaction to the use of the iodophor-impregnated drape.
Of the 135 patients, 43 had iodine listed as an allergy, 85 had shellfish, 20 had iodinated contrast media, and 3 had povidone iodine. Sixteen patients had a cluster of iodine-related allergies. There were no intraoperative reports of an allergic reaction to this drape. There were four superficial wound problems, none of which were documented to relate to an allergic dermatitis reaction, and none required further surgery.
Patients reporting iodine-related allergies were present in 1.38% of patients undergoing hip or knee arthroplasty in our series. We encountered no allergic reactions or adverse outcomes that could be attributed to the use of iodiphor impregnated drapes in these patients.
含碘碘伏的粘性手术巾的使用几乎已普遍纳入关节置换术铺巾技术的标准操作中。计划进行关节置换的患者中与碘相关的过敏反应，在采取最佳行动方案以尽量减少并发症并优化手术效果方面构成了挑战。
这是一个回顾性病例系列，研究对象是在一家专门的骨科医院接受全髋关节或膝关节置换术铺巾时使用含碘碘伏手术巾且有记录的碘相关过敏患者。2015年至2023年期间，对9816例全髋关节置换术和全膝关节置换术病例进行了回顾，记录到135例有碘相关过敏反应，患病率为1.38%。回顾术中及术后记录，以筛查可能与使用含碘碘伏手术巾的不良反应相关的过敏反应或伤口愈合问题。
在135例患者中，43例将碘列为过敏原，85例对贝类过敏，20例对碘化造影剂过敏，3例对聚维酮碘过敏。16例患者有一系列与碘相关的过敏反应。没有关于该手术巾术中过敏反应的报告。有4例浅表伤口问题，均未记录与过敏性皮炎反应相关，且均无需进一步手术。
在我们的系列研究中，接受髋或膝关节置换术的患者中有1.38%报告有碘相关过敏反应。在这些患者中，我们未遇到可归因于使用含碘碘伏手术巾的过敏反应或不良后果。
