title: Are allergic reactions to skin clips associated with delayed wound healing?
abstract: BACKGROUND
  Metal skin clips are used in surgery. They may contain metals that might cause allergic reactions and delayed wound healing.
  
  
  METHODS
  The metal composition of 18 different surgical clamps was examined. The allergy status of 184 patients was determined by patch tests and was correlated with the clinical outcome of wound healing after application of skin clips.
  
  
  RESULTS
  Skin clips contained chromium, nickel, molybdenum, cobalt, and titanium in concentrations high enough to cause allergic reactions. Eighteen percent of the men and 23% of the women were sensitive to nickel and 16% of the men to chromium. We found a positive correlation between the grade of nickel allergy and the reaction to the skin clips.
  
  
  CONCLUSIONS
  Our study suggests that allergic reactions and delayed wound healing can be caused by the use of surgical skin clips. Therefore skin clips are not recommended for patients with a history of contact dermatitis to metals and/or atopy.
authors.affiliation: Orthopedic Hospital Gersthof, University of Vienna, Austria.
authors.forename: C G
authors.initials: CG
authors.lastname: Lhotka
authors.forename: T
authors.initials: T
authors.lastname: Szekeres
authors.forename: M
authors.initials: M
authors.lastname: Fritzer-Szekeres
authors.forename: G
authors.initials: G
authors.lastname: Schwarz
authors.forename: I
authors.initials: I
authors.lastname: Steffan
authors.forename: M
authors.initials: M
authors.lastname: Maschke
authors.forename: G
authors.initials: G
authors.lastname: Dubsky
authors.forename: M
authors.initials: M
authors.lastname: Kremser
authors.forename: K
authors.initials: K
authors.lastname: Zweymüller
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000485:Allergens / Q000009:adverse effects*; D000497:Alloys / Q000009:adverse effects*; D017449:Dermatitis, Allergic Contact / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009532:Nickel / Q000009:adverse effects; D010328:Patch Tests; D013528:Surgical Staplers / Q000009:adverse effects*; D016896:Treatment Outcome; D014945:Wound Healing
chemical_list: D000485:Allergens; D000497:Alloys; D009532:Nickel