Abstract:
Chlorhexidine (CHD) is commonly included in surgical antiseptics and can be associated with adverse reactions ranging from contact dermatitis to anaphylaxis. A 32-year-old female presented to the OR for facial fat grafting. Surgical sites were prepped with CHD gluconate or topical iodine. Donor and recipient sites were infiltrated with local anesthetic injection prior to fat harvest and facial injection. Eleven days later, she presented with new painful, pruritic rash over donor sites where CHD had been applied prior to local anesthetic infiltration. Treatment with topical clobetasol and prednisone taper resulted in complete symptom resolution. This patient\'s response most likely represented a delayed type IV, T-cell mediated hypersensitivity. CHD is a known trigger of allergic reactions. Infiltration of local anesthetic may introduce skin prep into the subcutaneous tissue akin to intradermal testing. For those with delayed cutaneous reactions, steroids may provide symptomatic relief.
摘要:
洗必泰(CHD)通常包括在外科抗菌剂中,并且可能与从接触性皮炎到过敏反应的不良反应有关。一名32岁的女性前往手术室进行面部脂肪移植。手术部位用CHD葡萄糖酸盐或局部碘准备。在脂肪收获和面部注射之前,用局部麻醉剂注射浸润供体和受体部位。11天后,她提出了新的痛苦,在局部麻醉浸润之前应用CHD的供体部位出现瘙痒性皮疹。局部使用氯倍他索和泼尼松锥度治疗可完全缓解症状。这个病人的反应很可能是延迟的IV型,T细胞介导的超敏反应。CHD是已知的过敏反应的触发因素。局部麻醉剂的浸润可能会将皮肤准备引入皮下组织,类似于皮内测试。对于那些皮肤反应延迟的人,类固醇可以缓解症状。