Blistering rash in the area of a surgical incision
Question:
11/5/2024
Contact allergy to suture material? I have a patient who developed an itchy, blistering rash in the incision area after hip replacement (titanium hip, ceramic parts). He has different suture material:
Hip capsule: bond excel (coated polyester)
Deep fascia: strata fix PDS
Deep dermal and adipose tissues: coded vicryl polyglactin
Skin: running strategic spiral monocryl
The rash does not respond to typical steroids. The hip is working well, the joint is not becoming loose, but the rash is not going away. Can I patch test for the suture material? What do I use for testing?
Answer:
A rash localized to the area of a surgical incision would be more likely secondary to a material placed on the skin surface such as povidone, a topical antibiotic, or a medical adhesive than a suture material. If the rash has persisted for longer than 6 weeks it may warrant a biopsy, ideally including a part of the suture material, to help determine the diagnosis.
https://emedicine.medscape.com/article/1128404-overview?form=fpf
Maury CA, Gruson KI, Tabeayo E, Gruson LM, Merchan ECR. Allergic Contact Dermatitis (ACD) to Topical Products in Orthopedic Surgery: Clinical Characteristics and Treatment Strategies. Arch Bone Jt Surg. 2023;11(10):604-616.
Eric Macy, MD, MS, FAAAAI