Miller Florian, Fulweiler Bernadette, Feddema Tyler, Shah Suken A, Garg Sumeet
Children's Hospital Colorado, Aurora, CO, USA.
Nemours Children's Hospital, Orlando, FL, USA.
J Pediatr Soc North Am. 2024 Apr 5;7:100045. doi: 10.1016/j.jposna.2024.100045. eCollection 2024 May.
Dermatitis from the use of 2-Octyl cyanoacrylate liquid wound closure adhesives after scoliosis surgery is believed to be allergic reactions to some components of wound closure systems. Previous exposure to the closure system can increase the risk of allergic dermatitis with subsequent exposures. Two cases of allergic contact dermatitis in pediatric patients who underwent posterior spine fusion surgery using 2-Octyl cyanoacrylate wound adhesive are reported here. Successful management can include a protocol developed of topical corticosteroids, mupirocin, emollient ointment, and antihistamines. In severe cases, tapered oral steroids can be administered to treat diffuse allergic dermatitis. Awareness of potential risks is essential, and health care providers should be proficient in managing dermatitis related to this closure system.
(1)2-Octyl cyanoacrylate has gained popularity among spine surgeons due to lower infection rates, decreased OR time, and high rates of patient satisfaction.(2)While uncommon, there have been cases of hypersensitivity reactions (ranging from mild erythema to diffuse full-body allergic dermatitis) in the pediatric spine community.(3)The majority of hypersensitivity reactions respond to a combination of topical medium potency corticosteroids, topical antibacterial agents, emollient ointment, and as-needed oral antihistamines.
脊柱侧弯手术后使用2-氰基丙烯酸辛酯液体伤口闭合粘合剂引起的皮炎被认为是对伤口闭合系统某些成分的过敏反应。先前接触过该闭合系统会增加后续接触时发生过敏性皮炎的风险。本文报告了两例使用2-氰基丙烯酸辛酯伤口粘合剂进行后路脊柱融合手术的儿科患者发生过敏性接触性皮炎的病例。成功的处理方法可包括制定一套使用外用皮质类固醇、莫匹罗星、润肤软膏和抗组胺药的方案。在严重病例中，可给予逐渐减量的口服类固醇来治疗弥漫性过敏性皮炎。意识到潜在风险至关重要，医疗保健人员应熟练掌握与该闭合系统相关的皮炎的处理方法。
（1）2-氰基丙烯酸辛酯因感染率较低、手术时间缩短和患者满意度高而在脊柱外科医生中受到欢迎。（2）虽然不常见，但在儿科脊柱领域已有过敏反应病例（从轻度红斑到弥漫性全身过敏性皮炎）。（3）大多数过敏反应可通过外用中效皮质类固醇、外用抗菌剂、润肤软膏和必要时口服抗组胺药联合治疗。
