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New research · Allergy & Immunology
The Journal of the American Academy of Orthopaedic Surgeons · 17h
Cohort studyThe Journal of the American Academy of Orthopaedic Surgeons · 2026

Chlorhexidine Gluconate and Hypersensitivity From 2-Octyl Cyanoacrylate Mesh Dressings.

Klara Aastroem, Garrett Ossolinski, Laura Silverio … Roshan P Shah
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Allergy & ImmunologyCohort study

Thorough chlorhexidine removal before mesh dressing linked to fewer skin hypersensitivity reactions

Chlorhexidine Gluconate and Hypersensitivity From 2-Octyl Cyanoacrylate Mesh Dressings.

Klara Aastroem et al. · The Journal of the American Academy of Orthopaedic Surgeons · 2026
Background

Both 2-octyl cyanoacrylate mesh dressings and chlorhexidine gluconate are independently associated with hypersensitivity.

Purpose

We hypothesized that an enhanced washing protocol before dressing application would reduce the incidence of hypersensitivity.

Methods

This retrospective study reviewed 214 hip and knee arthroplasty patients receiving 2% chlorhexidine gluconate/70% isopropyl alcohol skin paint and a 2-octyl cyanoacrylate mesh dressing.

n = 138
Results

far fewer allergic skin reactions when the antiseptic was thoroughly washed off first

OR 0.16 (95% CI 0.04 to 0.70)
null = 10.040.70
CI excludes the null - significant
More results

The two reactions in the enhanced protocol occurred immediately and both subsequently revealed a history of adhesive allergy.

No differences were observed in delayed wound healing, superficial infection, or deep infection (P = 0.75, 0.53, and 1, respectively).

Prior mesh exposure had no effect on hypersensitivity.

“
Conclusion · 1 of 3

We observed that thorough removal of durable chlorhexidine paint was associated with a lower incidence of hypersensitivity after application of impermeable mesh dressings.

Conclusion · 2 of 3

The study findings support efforts to reduce chlorhexidine concentration on the skin before the application of dressings.

Conclusion · 3 of 3

In the absence of a prospective study, we recommend making this inexpensive and simple protocol change before application of a 2-octyl cyanoacrylate mesh dressing to surgical wounds.

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