Yes, it is possible to be allergic to surgical glue, though this reaction is relatively uncommon compared to the widespread use of these adhesives. Surgical glue is a liquid adhesive used by medical professionals to close incisions and wounds, offering an alternative to traditional stitches or staples. These products provide a quick, comfortable, and often cosmetically favorable way to close a wound, but they can sometimes trigger an immune response. Understanding the components, recognizing a true allergic reaction, and knowing the medical steps that follow is important for anyone undergoing a procedure where these adhesives are used.
How Surgical Glues Are Formulated
The basis of most modern surgical adhesives is a family of compounds called cyanoacrylates. These are liquid monomers that rapidly harden into a strong polymer when exposed to the moisture on the skin’s surface. The specific molecules used are often 2-octyl cyanoacrylate or n-butyl cyanoacrylate, chosen for their flexibility and low toxicity. These compounds offer several advantages, including creating a microbial barrier and eliminating the need for suture removal.
The allergic response is not usually caused by the hardened glue, but by the liquid monomer components or their degradation products. As the cyanoacrylate polymerizes and breaks down over time, it can release trace amounts of substances, such as formaldehyde, which is a known sensitizer. This process triggers an immune response, specifically a Type IV delayed hypersensitivity reaction, which is mediated by immune T-cells rather than immediate antibodies.
Distinguishing Allergic Reactions from Common Irritation
It is important to differentiate a true allergy from the more common, mild skin irritation that often occurs after surgery. Expected irritation, known as irritant contact dermatitis, is localized redness, minor itching, or slight discomfort that remains confined to the immediate edge of the adhesive or the area where a tape dressing was removed. This common irritation often appears quickly and resolves within a day or two after the adhesive is removed.
A true allergic contact dermatitis, however, presents with more pronounced and persistent symptoms. The most defining characteristic is its delayed onset, often appearing 24 to 72 hours, or sometimes up to two weeks, after the glue application. Signs of a true allergy include intense itching, the development of a raised, blistered, or eczematous rash that often extends beyond the exact contact line of the adhesive, or weeping and crusting at the site. The immune system’s T-cells initiate a prolonged inflammatory response that requires medical intervention.
Medical Diagnosis and Treatment Protocols
If an allergic reaction to surgical glue is suspected, consulting the operating surgeon or a dermatologist immediately is the first step. The healthcare provider will attempt to differentiate the symptoms from a surgical site infection, which requires a different treatment approach. A key diagnostic distinction is that an allergic reaction typically lacks the local heat and pus discharge associated with an infection.
For definitive diagnosis, a doctor may recommend patch testing. Small amounts of the suspected allergens, like cyanoacrylate or its breakdown products, are applied to the skin and monitored for a reaction over several days. If a reaction is confirmed, the immediate treatment involves removing any remaining glue if it is safe to do so without compromising the wound.
Treatment for the resulting contact dermatitis typically includes the application of a topical steroid cream to reduce the inflammation and rash. Oral antihistamines may also be prescribed to help manage the intense itching. In severe cases where the rash is widespread or intense, a short course of oral steroids may be necessary to suppress the systemic immune response.
Alternative Wound Closure Methods
For individuals who have confirmed a sensitivity to surgical glues, several alternative methods are available to close surgical wounds in the future. The most traditional option is the use of sutures, commonly referred to as stitches. These can be non-absorbable, requiring later removal, or absorbable, dissolving naturally within the body. Sutures are often used for deeper layers of tissue and areas of high skin tension.
Another common alternative is surgical staples, which provide a quick and secure closure, particularly for longer incisions. Additionally, adhesive strips, such as Steri-Strips, can be used to hold the edges of a wound together, providing support that is generally gentler on the skin than liquid glue. These strips can be used alone or in conjunction with deep sutures. Selecting the appropriate alternative method is a decision made by the surgical team based on the wound’s location, size, and the patient’s confirmed sensitivities.