From the Guidelines
Yes, it is possible to have a delayed skin reaction to surgical glue, which can occur due to a type IV hypersensitivity reaction mediated by T-cells, as described in the context of drug allergy reactions 1.
Delayed Hypersensitivity Reactions
Delayed hypersensitivity reactions to surgical adhesives can occur days to weeks after application, presenting as persistent redness, itching, swelling, or blistering at the surgical site.
- These reactions are typically diagnosed through patch testing or delayed intradermal testing, as outlined in the 2022 practice parameter update on drug allergy 1.
- The testing procedures for delayed hypersensitivity reactions involve applying a small amount of the suspected allergen to the skin and observing for a reaction over a period of time, usually 24-72 hours 1.
Treatment and Management
If a delayed skin reaction to surgical glue is suspected, treatment usually involves:
- Removing any remaining adhesive (if possible)
- Applying topical corticosteroids like hydrocortisone 1% cream 2-3 times daily for 7-10 days
- Taking oral antihistamines such as cetirizine 10mg daily or diphenhydramine 25-50mg every 6 hours as needed for itching
- In severe cases, oral steroids might be prescribed, as noted in the guidelines for managing drug allergy reactions 1.
Importance of Prompt Medical Attention
It is essential to contact a healthcare provider promptly if symptoms of a delayed skin reaction to surgical glue occur, as timely treatment can help alleviate symptoms and prevent further complications.
- The healthcare provider may perform patch testing or delayed intradermal testing to confirm the diagnosis and determine the best course of treatment, as recommended in the 2022 practice parameter update on drug allergy 1.
From the Research
Delayed Skin Reaction to Surgical Glue
- A delayed skin reaction to surgical glue is possible, as evidenced by several studies 2, 3, 4, 5, 6.
- These reactions can occur due to various factors, including the type of surgical glue used, individual patient sensitivity, and the presence of other irritants or allergens 3, 4.
- The timing of the reaction can vary, with some studies reporting reactions occurring within a few days to several weeks after surgery 3, 6.
- The severity of the reaction can also vary, ranging from mild to severe, with some cases requiring treatment with steroids or other interventions 3, 6.
Types of Surgical Glue Associated with Delayed Skin Reactions
- 2-Octyl cyanoacrylate, a common surgical glue, has been identified as a potential cause of delayed skin reactions 3, 6.
- Other types of surgical glue, such as polydioxanone, have also been associated with skin reactions, although these may be less common 2.
- The use of multiple surgical products, including antiseptics, anesthetics, and bandages, can increase the risk of skin reactions 4.
Diagnosis and Management of Delayed Skin Reactions
- Patch testing can be used to diagnose delayed skin reactions to surgical glue 3, 5.
- Management of delayed skin reactions may involve treatment with topical or systemic steroids, as well as avoidance of the offending agent 3, 6.
- In some cases, alternative surgical products or techniques may be necessary to prevent future reactions 5.