Atopic illness, elevated danger for surgical problems linked

Key takeaways:

• Following breast reconstruction, the chance for revision surgical procedure was larger amongst these with vs. with out atopic pores and skin situations.
• After bone grafting, this danger was additionally raised in these with atopic illness.

ORLANDO — Adults with vs. with out atopic illness had increased dangers for difficulties after breast reconstruction and bone grafting, in accordance with information introduced on the American School of Allergy, Bronchial asthma & Immunology Annual Scientific Assembly.

Joshua Wang

“These outcomes counsel that clinicians ought to maintain a affected person’s atopic historical past in thoughts when planning and following up after bone grafting,” Joshua Wang, MS, lead writer of the examine on bone grafting and medical scholar on the College of Texas Medical Department John Sealy Faculty of Medication, advised Healio. “Being conscious of that added danger will help information counseling, nearer monitoring and doubtlessly earlier intervention if problems come up.”

Philong Nguyen

Philong Nguyen, BS, lead writer of the examine on breast reconstruction and medical scholar on the College of Texas Medical Department John Sealy Faculty of Medication, added that “recognizing atopic illness as a possible danger issue and successfully speaking this to sufferers stays important.”

Breast reconstruction

Within the first examine, Nguyen and colleagues assessed girls breast most cancers sufferers who underwent implant-based reconstruction between 2002 and 2022 to uncover how the chance for implant-related problems after surgical procedure differs amongst these with vs. with out prior diagnoses of eczema, dermatitis or different allergic pores and skin situations.

Researchers used propensity scores to match the teams with one another primarily based on demographics, comorbidities, autoimmune illnesses and therapy exposures together with radiation, chemotherapy, hormone remedy and steroids. This yielded 10,205 girls in every group.

In contrast with girls with out atopic situations, the chance for implant problems after reconstruction was considerably raised amongst girls with atopic situations (RR = 1.2; P

On the 1-year, 2-year and 3-year marks following surgical procedure, the chance for revision surgical procedure was considerably larger amongst these with vs. with out atopic situations (RR = 1.1; P P .004) and implant an infection (RR = 1.2; P .0009).

The danger for capsular contracture was additionally considerably heightened within the group with vs. with out atopic situations, however this was discovered on the 2-year and 3-year marks (RR = 1.2; P .0005). Equally, researchers reported that ladies with vs. with out atopic situations had a considerably raised danger for implant rupture at these two time factors (RR = 1.4; P .0457).

“Our matter ought to ideally be additional evaluated by potential cohort research to ascertain causation,” Nguyen advised Healio. “Whereas our present work leverages a big nationwide database with an intensive pattern dimension, it will probably solely exhibit associations, not causal relationships.

“In the end, our examine helps lay the groundwork for future analysis to discover these causal hyperlinks extra straight,” he added.

Bone grafting

In a distinct examine, Wang and colleagues assessed adults who underwent bone grafting procedures between 2017 and 2023 by way of the TriNetX analysis community to find out how the chance for problems after surgical procedure differs amongst these with vs. with out atopic illnesses (bronchial asthma, atopic dermatitis and allergic rhinitis).

Just like the breast reconstruction examine, researchers used propensity scores to match the teams with one another primarily based on demographics (age, intercourse, race and BMI) and comorbidities (hypertension, diabetes mellitus, coronary artery illness, persistent kidney illness, COPD and smoking), and this resulted in 19,334 sufferers in every group.

The danger for an infection/wound problems was considerably elevated amongst these with vs. with out atopic illness when evaluated at 90 days after the bone grafting process (HR = 1.19; 95% CI, 1.08-1.32). This sample was additionally true for the chance for osteomyelitis (HR = 1.29; 95% CI, 1.12-1.48) and the chance for {hardware} elimination (HR = 1.22; 95% CI, 1.05-1.41) at this timepoint, in accordance with the examine.

Notably, researchers discovered that every of the above dangers continued to be considerably heightened within the group with vs. with out atopic illness on the 2-year mark following surgical procedure: an infection/wound problems (HR = 1.2; 95% CI, 1.11-1.31), osteomyelitis (HR = 1.2; 95% CI, 1.08-1.33) and {hardware} elimination (HR = 1.21; 95% CI, 1.11-1.33).

Different dangers that have been considerably raised amongst these with vs. with out atopic illness at the moment level included mechanical loosening (HR = 1.35; 95% CI, 1.17-1.56) and revision surgical procedure (HR = 1.16; 95% CI, 1.09-1.25).

“We have been stunned by the consistency of the elevated danger for osteomyelitis and {hardware} elimination amongst sufferers with atopic illness,” Wang advised Healio. “Whereas we anticipated some affiliation between atopy and mechanical problems, seeing these particular dangers persist throughout each short- and long-term follow-up was sudden.”

The examine additional reported that the chance for graft failure, pathological fractures, debridement and opioid abuse within the atopic illness group didn’t considerably differ from the group with out atopic illness at 90 days or 2 years.

“Sooner or later, we hope to discover this additional by trying on the administration of atopic situations and whether or not optimizing illness management will help mitigate among the dangers we noticed in our examine,” Wang mentioned.

For extra info:

Philong Nguyen, BS, will be reached at longnguy@utmb.edu.

Joshua Wang, MS, will be reached at joswang@utmb.edu.

Sources/Disclosures

Supply:

Nguyen P, et al. Affiliation between atopic pores and skin illness and implant-related problems in breast reconstruction. Offered at: ACAAI Annual Scientific Assembly; Nov. 6-10, 2025; Orlando.

References:

• Individuals with allergic reactions or eczema could face increased danger of surgical problems. https://annualmeeting.acaai.org/2025/surgical-complications.cfm. Printed Nov. 6, 2025. Accessed Nov. 6, 2025.
• Wang J, et al. Atopic illness is related to elevated problems following bone grafting: A multicenter retrospective cohort examine. Offered at: ACAAI Annual Scientific Assembly; Nov. 6-10, 2025; Orlando.

Disclosures:
Nguyen and Wang report no related monetary disclosures.

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