A 71-year-old woman, discharged after total hip replacement arthroplasty, returned to the hospital on postoperative day 9 with a 3-day history of itchy eczematous lesion around the surgical wound (Fig. ). The patient was afebrile, and there was no warmth, redness, or tenderness on wound examination. A blood test at that time showed the following: white blood cell (WBC) count, 5100/μL (normal 4000–10,000/μL); erythrocyte sedimentation rate (ESR), 84 mm/h (normal 0–20 mm/h); and C-reactive protein (CRP), 4.43 mg/dL (normal 0–0.6 mg/dL). The patient's inflammatory markers were mildly elevated compared with the blood test results 5 days earlier: WBC, 3600/μL; ESR, 30 mm/h; and CRP, 2.46 mg/dL. Because SSI could not be ruled out, the patient received cefazolin, 2 g, intravenously. The next day, the patient was diagnosed with contact dermatitis at the dermatology clinic and treated with local steroid ointment without additional antibiotics. Also, the mesh applied at the surgical wound was removed immediately. The skin lesion resolved after 1 week of treatment.
A 31-year-old Caucasian woman with a BMI of 24.2 with no history of allergic contact dermatitis or drug allergy () was prepped with chlorhexidine gluconate and the following sutures were utilized: deep polyglactin 910, subcuticular poliglecaprone 25, polyglactin 910, and rapidly absorbing plain gut for the nipple. Five days later, there was no rash. Twenty-three days later, a pruritic, erythematous rash along the intramammary incision was noted. Diphenhydramine did not alleviate symptoms. The remaining DERMABOND PRINEO Skin Closure System was removed. The patient was given prednisone and scheduled with dermatology. One month later, the rash had resolved.