Dermatitis after spine fusion caused by liquid adhesive (2-Octyl cyanoacrylate).

Abstract

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.<h4>Key concepts</h4>(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.