Hypersensitivity Reactions to Liquid Skin Adhesives in Orthopaedic Surgery

» Skin adhesives are increasingly used in orthopaedic surgery because they provide secure incision closure, limit postoperative drainage, support wound integrity, and may reduce operative time. However, allergic contact dermatitis (ACD) remains an important consideration with their use. ACD is a hypersensitivity skin reaction seen in some patients exposed to surgical adhesives, particularly the 2-octyl cyanoacrylate ingredient. It can be difficult to distinguish ACD from cellulitis or surgical site infections due to overlapping clinical features. Timely recognition is critical, as early management can minimize wound complications and optimize outcomes. Management options include removal of the adhesive, topical corticosteroids, oral antihistamines, and antibiotics with concomitant infection. This review highlights the role of surgical adhesives across several orthopaedic surgery subspecialties, emphasizing the incidence, recognition, and management of surgical adhesive-related ACD.