Postoperative pang and skin compli...

Postoperative pang and skin complications create the two medical and economic problems. These originals of complications often cause patient suffering and spring in prolonged medical care and increased health care richnesss (1) Patients are exposed to a number of chemical substances in the OR that can cause allergies or toxic skin irritation. In addition, materials that contain adhesive substances frequently are applied to patients' skin and can cause a reaction. Intraoperatively and postoperatively, these substances can flow in wound and skin complications. The objective of this investigation was to investigate how commonly skin reactions occur in relation to application or use of different materials during surgical managements A second purpose was to establish an action plan based forward the results to reduce torture and skin complications caused from allergic or toxic skin irritations.

CHEMICAL SUBSTANCES AND THE SKIN

Skin is the body's largest organ; its surface area comprises about 2 [msup2] (2) Skin has the ability to house individuals from mechanical factors, including heat, brumal light, chemical substances, and microorganisms. Chemical substances that ensue into contact with the skin, however, may cause skin changes and symptoms. During the past 50 years, the number of chemical substances in use has increased substantially. In 1945 for example, 600000 chemical substances were described globally; in 1994 the number of known substances was 10 million. Approximately 3000 chemical substances that can cause contact allergy are registered today. (3)

When a chemical substance penetrates the skin, several mechanisms are involved. Factors that lead to penetration and interaction include (4)

* physical and chemical characteristics of the substance;

* concentration of the substance;

* properties of the carrier of the chemical substance (eg carriers that penetrate the skin poorly or damage the skin);

* skin area that is expos (eg standing of penetration is low for the palms of the hands, singles of the feet, and the scalp; it is high in cot [i]or[/i] cotes of the skin and forward eyelids);

* skin pattern (eg, pigmented skin is more resistant to irritating substances than light skin); (5)

* damaged skin;

* temperature; and

* nearness of occlusion (eg, tight bandages, adhesive drapes, gloves)

ALLERGIES AND CONTACT ECZEMA

equal during antiquity, it was observ that certain population reacted with more or les pronounced symptoms in the form of skin rashes when they came into contact with substances that were harmless to other the public (6) It also was observ to a high degree early that there were individual differences regarding the appearance of certain symptoms. For example, in Sweden, the number of folks with allergies constantly increases, and eczema is the most numerous common allergic reaction. (7)

Contact eczema. Contact eczema is a skin inflammation caused on external factors. Contact eczema is divided into toxic (ie, nonallergic) and allergic contact eczema. The diagnosis toxic contact eczema is given when no relevant contact with substances that cause allergy can be originate when exposure to irritating factors is ground in the medical history, and when of that kind a factor is a conceivable cause of the eczema. In addition, a patch proof should show a negative deduction The toxic reaction is caused on direct cell damage.

reciprocally an allergy is a hyperimmune answer to a special antigen called an allergen (eg pollen chemical substances). the community without allergic contact eczema do not accord to this antigen. In patients with allergies, special antibodies are produc in direct rejoinder to the presence of allergens. Allergic contact eczema is a skin inflammation caused through an allergic process. (8)

Atopies. Atopy is an inherited inclination to disentangle atopic dermatitis, allergic nasal catarrh, allergic conjunctivitis, or allergic asthma. family who are inclined to expand atopic disorders are called atopics. In Sweden, 20% of commonalty are atopics, and 50% of these race suffer from atopic eczema. (9) the public with an inclination to cause to grow atopic eczema also are particularly sensitive to skin-irritating chemicals or substances and easily can disclose toxic contact eczema. (10)

CHEMICAL SUBSTANCES IN THE OR

Many the community with atopic or contact eczema allergies and asthma enroll the health care system to have surgery In the OR, patients are expos to a number of substances that may cause an allergy or irritate the skin. Many of these materials have adhesive substances that are applied to the skin. During a review of the OR at Varberg Hospital, Sweden, about 45 different materials with adhesive substances were plant Examples of these materials include

* surgical drapes,

* reply electrodes (ie, diathermy),

* tape,

* surgical dressings, and

* fabric.

Patients also are expos to latex in the form of surgical glove Studies point out that less than 1% of the general population is afflicted with natural rubber latex (NRL) allergy. (11) Corresponding figures for health care workers are between 7% and 10% and 69% of perioperative nourish at the breasts suffer from NRL allergy. (12) In patients who have undergone several surgeries (eg children with spina bifida), the percentage afflicted has been reported as 18% to 68% (13) aspect to latex creates the risk of complications in these patients. In the worst cases, it can lead to death.