Dressing-induced allergic contact dermatitis in total joint arthroplasty

Area of Science:

• Orthopedic Surgery
• Dermatology
• Allergy and Immunology

Background:

• Dressing-induced allergic contact dermatitis (DIACD) is a potential complication following orthopedic procedures.
• Understanding the incidence and risk factors for DIACD after total hip arthroplasty (THA) and total knee arthroplasty (TKA) is crucial for patient care.

Purpose of the Study:

• To determine the incidence of DIACD after THA and TKA.
• To identify risk factors associated with DIACD, including dressing types and patient characteristics.

Main Methods:

• Retrospective review of patients undergoing primary THA or TKA between 2019 and 2024.
• Analysis of medical records for DIACD diagnoses, medication use, patient demographics, and dressing exposures.

Main Results:

• A low incidence of 0.3% (61/23,396) for DIACD was observed, typically occurring around two weeks postoperatively.
• Mesh-adhesive dressings were most frequently implicated (41%).
• Higher risk was associated with TKA and never smoking, though effect sizes were negligible.

Conclusions:

• DIACD following joint arthroplasty is uncommon but clinically relevant.
• Mesh-adhesive dressings are the primary culprits, and prior dressing exposure may increase risk.
• Identifying patients undergoing TKA and non-smokers can help tailor dressing choices to mitigate DIACD risk.