Anderson Brady J, Tanenbaum Zachary G, Michael Alexander, Owen Scott R
Department of Otolaryngology Head and Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, United States.
J Surg Case Rep. 2024 Jul 6;2024(7):rjae103. doi: 10.1093/jscr/rjae103. eCollection 2024 Jul.
Chlorhexidine (CHD) is commonly included in surgical antiseptics and can be associated with adverse reactions ranging from contact dermatitis to anaphylaxis. A 32-year-old female presented to the OR for facial fat grafting. Surgical sites were prepped with CHD gluconate or topical iodine. Donor and recipient sites were infiltrated with local anesthetic injection prior to fat harvest and facial injection. Eleven days later, she presented with new painful, pruritic rash over donor sites where CHD had been applied prior to local anesthetic infiltration. Treatment with topical clobetasol and prednisone taper resulted in complete symptom resolution. This patient's response most likely represented a delayed type IV, T-cell mediated hypersensitivity. CHD is a known trigger of allergic reactions. Infiltration of local anesthetic may introduce skin prep into the subcutaneous tissue akin to intradermal testing. For those with delayed cutaneous reactions, steroids may provide symptomatic relief.
洗必泰（CHD）常用于手术消毒剂中，可能会引发从接触性皮炎到过敏反应等一系列不良反应。一名32岁女性因面部脂肪移植进入手术室。手术部位用葡萄糖酸洗必泰或局部碘进行了预处理。在脂肪采集和面部注射前，供体和受体部位均注射了局部麻醉剂。11天后，她在供体部位出现了新的疼痛性、瘙痒性皮疹，这些部位在局部麻醉剂浸润前曾使用过CHD。外用氯倍他索和逐渐减量的泼尼松治疗使症状完全缓解。该患者的反应很可能代表了迟发型IV型、T细胞介导的超敏反应。CHD是已知的过敏反应触发因素。局部麻醉剂的浸润可能会将皮肤预处理剂引入皮下组织，类似于皮内试验。对于有延迟性皮肤反应的患者，类固醇可能会缓解症状。
