Allergy to Prolene Sutures in a Dural Graft for Chiari Decompression

Case Reports in Medicine
Iahn CajigasAllan D Levi

Abstract

Allergy to Prolene suture is exceedingly rare with only 5 cases reported in the literature. There have been no such cases associated with neurosurgical procedures. Diagnosis is nearly always delayed in spite of persistent symptomatology. A 27-year-old girl with suspected Ehlers-Danlos, connective tissue disorder, underwent posterior fossa decompression for Chiari Type 1 malformation. One year later, the patient presented with urticarial rash from the neck to chest. Cerebrospinal fluid and blood testing, magnetic resonance imaging, and intraoperative exploration did not suggest allergic reaction. Eventually skin testing proved specific Prolene allergy. After suture material was removed, the patient no longer complained of pruritus or rash. This single case highlights the important entity of allergic reaction to suture material, namely, Prolene, which can present in a delayed basis. Symptomatology can be vague but has typical allergic characteristics. Multidisciplinary approach is helpful with confirmatory skin testing as a vital part of the workup.

References

Apr 1, 1988·Journal of the American Academy of Dermatology·R G Bennett
Oct 9, 2003·Contact Dermatitis·Leticia Sánchez-MorillasA R Domínguez Lázaro
Jan 25, 2006·Annals of Plastic Surgery·Jeffrey A AschermanDavid R Bickers
Jun 13, 2006·Canadian Journal of Ophthalmology. Journal Canadien D'ophtalmologie·Hak Sung ChungPaul J Bryar
Nov 23, 2012·The Journal of Laryngology and Otology·A TeymoortashS Steinbach-Hundt

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Citations

Jul 28, 2020·Contact Dermatitis·Francisco J Navarro-Triviño, Ricardo Ruiz-Villaverde
Mar 28, 2019·Irish Journal of Medical Science·Cillian ClancyPaul F Ridgway

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