Systematic Review and Meta-Analysis of Allergic Contact Dermatitis from 2-Octyl Cyanoacrylate Adhesives.
Daniel S Rouhani, Ashton Rosenbloom, Steven Zeng et al.
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In 30 seconds
This systematic review and meta-analysis examined allergic contact dermatitis (ACD) associated with 2-octyl cyanoacrylate adhesives used for surgical wound closure. It included 74 studies with 26,330 exposed patients; 20 analytic cohorts contributed to pooled incidence estimates. Overall pooled ACD incidence was 4% (95% CI 3% to 5%), with substantial heterogeneity (I2 = 94.5%; prediction interval 0% to 12%). Rates differed by specialty, and repeat exposure was associated with higher reaction rates. The authors conclude that ACD is a clinically meaningful, likely underrecognized complication.
Key findings
- Pooled ACD incidence was 4% (95% CI 3% to 5%), with substantial heterogeneity (I2 = 94.5%; prediction interval 0% to 12%).
- Incidence was 4% in orthopaedic cohorts and 8% in plastic surgery cohorts; specialty subgroup differences were significant (p = 0.015).
- Reaction rates rose from 1% to 3% after initial exposure to >20% in several cohorts after staged or repeat procedures.
- Earlier adhesive contact allergy and cosmetic acrylate exposure were identified as strong risk factors.
Why it matters
ACD can complicate postoperative wound care and may be missed or mistaken for other skin problems. The pooled estimate provides a broad indication of its frequency, while the marked variation between studies cautions against assuming a uniform risk. The association with repeat exposure highlights the importance of recognizing prior adhesive reactions when assessing postoperative skin symptoms.
What to keep in mind
The pooled estimate had substantial heterogeneity, and the review included randomized, observational, and case-based reports, so the evidence base was methodologically varied.