[Latex allergy and orthopedic surgery].

OBJECTIVE

Latex allergy is becoming a subject of extreme concern, especially in patients who have undergone multiple operations and/or have after effects of myelodysplasia. Presenting their data, the authors wish to make it aware to orthopaedic surgeons focusing on different risk groups, and at the same time advising on medical examinations, of the various measures to take.

METHODS

Twenty patients were tested (17 with spina bifida and 3 with cerebral palsy) for latex and ethylene oxide allergy, and with certain fruits known for their cross-reactivity. Atopic history has also been researched. The immunologic examination had been carried out by means of skin-tests with evidence of specific IgE antibodies being found.

RESULTS

Out of the twenty patients tested, eight had clinical signs of a latex allergy while 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), chestnut (1), hazelnut (3).

CONCLUSIONS

We confirm: 1) the increased risk of a latex allergy among patients with spina bifida: 47 per cent in our study; 2) the association of an ethylene oxide allergy, practically the only product used in the sterilisation of medical equipment; 3) a more and more frequent association to food allergies, in particular to fruits: 7 out of 11 patients in our study compared to 50 per cent in other published studies. The classical subject of atopy is not found here.

CONCLUSIONS

Against the increase of latex allergy, it is necessary to propose a strategy: firstly to determine the groups at risk: patients who have undergone multiple operations, atopic persons, isolated cases of food allergies, spina bifida cases. Then, to test them and if necessary, taking draconian measures concerning their medical environment; to identify them; to provide them with auto-injectable epinephrine; to give premedication, though with no success guarantee in case of anticipated surgical procedure. Finally, we recommend to manufacturers that all equipment and products should be free of latex.