Metal allergy after the Nuss procedure for pectus excavatum: a review
| Autor: | Jakub Kazik, Kacper Kroczek, Rafał Czajkowski, Kamil Leis, Przemysław Gałązka, Aleksandra Baska |
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| Rok vydání: | 2020 |
| Předmět: |
Thorax
medicine.medical_specialty Allergy pectus excavatum medicine.medical_treatment Dermatology Nuss procedure 030207 dermatology & venereal diseases 03 medical and health sciences 0302 clinical medicine Pectus excavatum bar allergy Immunology and Allergy Medicine Medical history Internal medicine allergy testing Review Paper business.industry medicine.disease RC31-1245 Surgery RL1-803 Antihistamine Implant business Complication |
| Zdroj: | Advances in Dermatology and Allergology/Postȩpy Dermatologii i Alergologii Advances in Dermatology and Allergology, Vol 37, Iss 6, Pp 848-852 (2021) |
| ISSN: | 1642-395X |
| DOI: | 10.5114/ada.2020.102094 |
| Popis: | Minimally invasive repair of pectus excavatum (MIRPE) technique (the Nuss procedure) is a minimally-invasive method that is commonly used in the treatment of pectus excavatum. An allergic reaction to the metal alloy bar that is implanted in the thorax during the procedure is a reported complication. We briefly review current literature concerning epidemiology, mechanisms and research results of allergic reactions after Nuss bar implantation. This allergic reaction occurs in approximately 2.7% of patients and is caused by metals used in the medical implant. The most common symptoms include fever and skin lesions such as allergic dermatitis. Elevated levels of C-reactive protein is a frequent finding in laboratory tests. In order to minimize the risk of such complications, taking a detailed allergy-based medical history and conducting allergy tests, i.e. patch test are required. Allergic reactions can be managed with conservative treatment such as general or topical glucocorticosteroid therapy and antihistamine agents. Severe allergic reactions can be addressed by implant revision, replacement of the steel bar with a titanium substitute or removal of the stabilization at all. Although the risk of an allergic reaction to titanium is smaller it still exists, the titanium substitute is not routinely used due to its higher cost and lesser plasticity which has a negative impact on matching a stabilizing bar during the surgery. Surgeons treating pectus excavatum should remember about the possible allergic reactions after implantation of the metal bar and be familiar with methods of diagnosis and treatment of those complications. |
| Databáze: | OpenAIRE |
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