WASHINGTON Presurgical patch testing may prompt surgeons to change devices to prevent allergic reactions in patients, Kurtis Reed said at the annual meeting of the American Contact Dermatitis Society.
To evaluate the clinical impact of a positive patch test before and after surgery, Mr. Reed, a third-year medical student at Mayo Medical School, Rochester, Minn., and his colleagues reviewed data from 22 patients who were patch tested before receiving an orthopedic device or pacemaker and 22 patients who were referred for patch testing after receiving their devices.
Five of the 22 patients who were tested prior to surgery tested positive to at least one component of the prospective device. In four of the five cases, the surgeon changed the device. In the fifth case, the surgeon proceeded as planned because the odds of an adverse reaction were low, and that patient has reported no complications, Mr. Reed said.
The surgeon proceeded as planned in 16 of the 17 patients whose patch tests were negative. The device was changed in one case based on the patient's allergy history, he said.
By contrast, the clinical value of patch testing was unclear in patients who were referred following surgery. Reasons for referral included 13 cases of unexplained rash at the device site, 8 cases of chronic joint pain, and 1 case of joint loosening.
Only 1 of the 22 patients (one of the cases of unexplained rash) tested positive to an orthopedic device component, but the device could not be confirmed as the source of the rash, Mr. Reed noted.