LATEX ALLERGY IN ORTHOPEDIC-SURGERY

Purpose of the study Latex allergy is becoming a subject of extreme co ncern, especially in patients who have undergone multiple operations a nd/or have after effects of myelodysplasia. Presenting their data, the authors wish to make it aware to orthopaedic surgeons focusing on dif ferent risk groups, and at the same time advising on medical examinati ons, of the various measures to take. Material and methods Twenty pati ents were tested (17 with spina bifida and 3 with cerebral palsy) for latex and ethylene oxide allergy, and with certain fruits known for th eir cross-reactivity. Atopic history has also been researched. The imm unologic examination had been carried out by means of skin-tests with evidence of specific IgE antibodies being found. Results Out of the tw enty patients tested, eight had clinical signs of a latex allergy whil e the twelve others were classified as being at risk. The results show that 11 out of 20 are allergic to latex, 4 of them have an allergy to ethylene oxide, and 7 have food allergies : banana (2), kiwi (1), che stnut (1), hazelnut (3). Discussion We confirm 1) the increased risk o f a latex allergy among patients with spina bifida : 47 per cent in 2) the association of an ethylene oxide allergy, practically the only pr oduct used in the sterilisation df medical equipment; 3) a more and mo re frequent association to food allergies, in particular to fruits : 7 out of 11 patients in our study compared to 50 per cent in other publ ished studies. The classical subject of atopy is not found here. Concl usion Against the increase of latex allergy, it is necessary to propos e a strategy : firstly to determine the groups at risk patients who ha ve undergone multiple operations, atopic persons, isolated cases of fo od allergies, spina bifida cases. Then, to test them and if necessary, taking draconian measures concerning their medical environment; to id entify them; to provide them with auto-injectable epinephrine; to give premedication, though with no success guarantee in case of anticipate d surgical procedure. Finally, we recommend to manufacturers that all equipment and products should be free of latex.